New Case Report on Punctal Stenosis -A Rare Complication of Dupilumab Therapy for Atopic Dermatitis

Background: Dupilumab is a biological medication that has been approved for the treatment of moderate to severe atopic dermatitis (AD) and has shown to have a significant therapeutic effect and ability to improve quality of life in clinical trials. Upper respiratory tract infection, headache, nasopharyngitis, injection-site reaction, herpes viral infection, and conjunctivitis were the most common side effects of dupilumab therapy. Dupilumab-induced lacrimal duct obstruction, also known as punctal stenosis, is a seldom observed and poorly researched side effect of the drug.

Aim: To introduce a new case of a young female with a history of AD but no prior significant ocular manifestations who developed right eye punctal stenosis while on Dupilumab therapy for one year.

Case Report: A 19-year-old female with a long-standing history of AD who developed severe punctal stenosis and continued tearing from her right eye in the last two months and was on dupilumab therapy for a year did not respond to conservative ophthalmological drugs, but completely improved after discontinuing dupilumab injection over a 6-month follow-up period.

Conclusions: Conjunctivitis is a well-known side effect of Dupilumab injections in AD disease patients. However, if conjunctivitis and weeping from the eye do not improve after ophthalmology treatment, punctal stenosis may be ruled out, and dupilumab should be stopped.