Case report of recalcitrant allergic contact eczema successfully treated with teriflunomide. Issue 4 (8th May 2019)

• Record Type: Journal Article
• Authors: Reis, Joel; Duarte, Sara; Sardoeira, Ana; Santos, Ernestina; Sanches, Madalena; Lobo, Inês; Selores, Manuela
• Is Part Of: Dermatologic therapy. Volume 32:Issue 4(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-05-08
• Subjects: case report -- eczema -- multiple sclerosis -- teriflunomide; Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; 616.5
• DOI: 10.1111/dth.12947
• Languages: English
• ISSNs: 1396-0296

Abstract

Abstract: Allergic contact dermatitis (ACD) is a type IV, delayed‐type reaction caused by skin contact with low‐molecular‐weight organic chemicals and metal ions that activate antigen‐specific T cells, primarily T‐helper 1 (Th1), in a sensitized individual, leading to skin eczema.First‐line treatments are based on avoidance of causal agents and topical corticosteroids/immunomodulators. In recalcitrant cases, chronic oral immunosuppressive agents may be used, but they may have serious adverse effects and do not address the immunological disfunction. We report a case of severe ACD, unresponsive to topical or oral immunosuppressive therapy, which resolved itself after treatment with teriflunomide (TF) 14 mg/daily used for multiple sclerosis. TF is a once‐daily, oral selective and reversible dihydroorotate dehydrogenase inhibitor, revealing a new treatment option for ACD.