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Investigation of morphological, vascular and biochemical changes in the skin of an atopic dermatitis (AD) patient in response to dupilumab using raster scanning optoacoustic mesoscopy (RSOM) and handheld confocal Raman spectroscopy (CRS)

      Dupilumab is a fully human monoclonal IgG4 antibody that inhibits the IL-4 and IL-13 signal pathways [
      • Beck L.
      • Thaci D.
      • Hamilton J.D.
      • et al.
      Dupilumab treatment in adults with moderate-to-severe atopic dermatitis.
      ]. It was approved on March 28, 2017 by US Food and Drug Administration (FDA) for treatment of moderate to severe atopic dermatitis (AD). It has a good treatment response with improvements in both physician reported outcome measures such as Eczema Area Severity Index (EASI) and patient reported outcomes measures such as Dermatology Life Quality Index (DLQI) and pruritus scores [
      • Blauvelt A.
      • de Bruin-Weller M.
      • Gooderham M.
      • et al.
      Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial.
      ]. Maximal clinical improvement in AD patients treated with dupilumab was seen at about 4–6 weeks [
      • Wollenberg A.
      • et al.
      Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II.
      ], and improvements in molecular signature of lesional skin was seen at 4 weeks [
      • Hamilton J.D.
      • Suárez-Fariñas M.
      • Dhingra N.
      • et al.
      Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis.
      ].

      Abbreviations:

      AD (atopic dermatitis), RSOM (raster scanning optoacoustic mesoscopy), CRS (confocal Raman spectroscopy), EASI (Eczema Area Severity Index), DLQI (Dermatology Life Quality Index and TBV, total blood volume)
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