Acquired perforating dermatosis successfully treated with dupilumab

Abstract Acquired perforating dermatosis (APD) is a disorder of transepidermal elimination of keratin, collagen or elastic fibers. APD is mainly associated with diabetes mellitus and chronic kidney disease. We present the case of a 66‐year‐old male, poorly controlled diabetic with peripheral arterial disease, obesity, arterial hypertension, Cushing's syndrome and chronic kidney disease requiring hemodialysis who develops an acquired perforating dermatosis. Due to the patient's comorbidities, treatment with corticosteroids, cyclosporine and phototherapy is not possible. He does not respond to gabapentinoids or allopurinol. The outbreaks of skin lesions and pruritus were accentuated in situations of renal function deterioration; however, hemodialysis did not improve her dermatosis, causing a great deterioration of her quality of life. It was decided to start treatment with dupilumab with the dosage used in atopic dermatitis, achieving a complete response of both pruritus and skin lesions. With this case, we want to show how dupilumab can be an effective tool to treat acquired perforating dermatosis.