After an injury, the body may form unwanted reminders in the form of keloids, fibrotic
overgrowths caused by injury to the reticular dermis. Accompanying these raised lesions are pain
and pruritus, significantly impacting quality of life. Keloids exhibit elevated levels of
interleukin-4 receptors (IL-4R), which upregulate profibrotic cytokines. Dupilumab, a
monoclonal IgG4 antibody, is a potential treatment option by inhibiting IL-4R signaling. While
this approach is promising, its application for keloid treatment is novel. Therefore, the efficacy of
dupilumab was assessed to determine its potential use for keloids.
An electronic literature search was conducted using search terms such as “keloid” and “dupilumab.” Following article collection, studies were selected for using criteria such as exclusion of articles with inability to separate dupilumab from other treatments, no specification of keloids, and non-human studies.
A review of five cases had positive outcomes such as substantial keloid regression, relief of pruritus and pain, improved appearance, and reduced new keloid formation. Two cases reported negative outcomes including no changes in keloid size or symptoms, enlargement of existing lesions, development of new keloids, and symptoms returning within weeks of missing a dose. Study limitations include varying durations of treatment and differing keloid etiologies.
Despite various treatment options, keloid management remains challenging. However, dupilumab is a promising therapeutic by inhibiting IL-4R induced keloid formation. Although a majority of studies revealed positive responses to dupilumab, some cases reported alarming findings such as increased keloid size and new growth. Therefore, dupilumab should be used for patients where other therapeutics were ineffective. Future studies should focus on determining optimal duration of treatment and likelihood of symptom recurrence after discontinuing dupilumab. Addressing these gaps will pave the way for more effective long-term keloid therapies.
An electronic literature search was conducted using search terms such as “keloid” and “dupilumab.” Following article collection, studies were selected for using criteria such as exclusion of articles with inability to separate dupilumab from other treatments, no specification of keloids, and non-human studies.
A review of five cases had positive outcomes such as substantial keloid regression, relief of pruritus and pain, improved appearance, and reduced new keloid formation. Two cases reported negative outcomes including no changes in keloid size or symptoms, enlargement of existing lesions, development of new keloids, and symptoms returning within weeks of missing a dose. Study limitations include varying durations of treatment and differing keloid etiologies.
Despite various treatment options, keloid management remains challenging. However, dupilumab is a promising therapeutic by inhibiting IL-4R induced keloid formation. Although a majority of studies revealed positive responses to dupilumab, some cases reported alarming findings such as increased keloid size and new growth. Therefore, dupilumab should be used for patients where other therapeutics were ineffective. Future studies should focus on determining optimal duration of treatment and likelihood of symptom recurrence after discontinuing dupilumab. Addressing these gaps will pave the way for more effective long-term keloid therapies.