Use of an oral phosphodiesterase-4 inhibitor (apremilast) for the treatment of chronic, severe atopic dermatitis: a case report

Author(s): Farahnik, Benjamin; Beroukhim, Kourosh; Nakamura, Mio; Abrouk, Michael; Zhu, Tian Hao; Singh, Rasnik; Lee, Kristina; Bhutani, Tina; Koo, John; Liao, Wilson | Abstract: Atopic dermatitis (AD) is a common inflammatorydermatosis characterized by pruritus, erythema,induration, and lichenification. Current treatmentoptions for generalized atopic dermatitis arelimited and have potentially serious adverse effects,especially in patients with severe, chronic AD whofrequently require systemic anti-inflammatory agents.Apremilast, an oral phosphodiesterase-4 inhibitor, wasFDA approved in September 2014 for the treatmentof moderate-to-severe plaque psoriasis. However, itsupstream anti-inflammatory effects, ease of use asan oral agent, and mild side-effect profile make it aninteresting treatment option for AD as well. Herein,we present a patient with a life-long history of ADrecalcitrant to topical steroids and cyclosporine whoattained subjective and objective improvement inpruritus and erythema after 10-week treatment withapremilast.