ArticleClinical, cosmetic and investigational dermatology2026
Stapokibart for Facial-Predominant AD-Like Dermatoses: A Retrospective Real-World Case Series Highlighting Response Heterogeneity.
Article in Clinical, cosmetic and investigational dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Facial-predominant inflammatory dermatoses are diagnostically heterogeneous and may overlap with atopic dermatitis (AD), contact dermatitis, rosacea-like inflammation, and autoimmune mimics. Stapokibart, an IL-4Rα-targeted monoclonal antibody, has demonstrated efficacy in moderate-to-severe AD, but real-world experience in facial-predominant AD-like presentations remains limited. Methods: We retrospectively reviewed five unpublished patients with facial-predominant inflammatory dermatoses treated with stapokibart in routine practice. Clinical phenotype, diagnostic work-up, prior and concomitant therapy, dosing, symptom scores, treatment course, recurrence, and adverse events were summarized descriptively. The cohort was not intended as a diagnostically uniform efficacy population, and no formal hypothesis testing was performed. Results: Five women aged 28-75 years were included. Pruritus numerical rating scale changed from a median of 3 (range, 2-4) at baseline to 1 (range, 0-3) at first follow-up; four patients improved and one worsened. All three patients with a well-supported facial-predominant AD phenotype showed rapid improvement in facial lesions and pruritus after stapokibart. One of these patients developed an injection-site reaction that led to treatment discontinuation; no serious adverse events were observed. One patient initially treated for AD-like facial dermatitis was subsequently evaluated for possible early clinically amyopathic dermatomyositis after telangiectatic and mildly atrophic features became more apparent. Another patient with an incompletely characterized AD-like facial eruption worsened on day 2 after stapokibart. Conclusion: In this small case series, rapid improvement was observed in all three patients with a well-supported facial-predominant AD phenotype, whereas atypical or incompletely characterized eruptions showed greater diagnostic complexity and variable outcomes. These preliminary observations support further investigation of stapokibart in facial-predominant AD while underscoring the need for careful phenotyping before IL-4Rα blockade.
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