Abstract: 【Abstract】 Objective To evaluate the clinical efficacy and safety of dupilumab in the treatment of endogenous hyperkeratotic hand-foot eczema. Methods Five patients with endogenous hyperkeratotic hand-foot eczema who showed inadequate response to conventional therapies were included in this case-series study and treated with dupilumab. Baseline scores before treatment were used as controls. During follow-up, treatment efficacy was quantitatively evaluated using the Hand Eczema Severity Index （HECSI）, and adverse events were recorded. Results Five patients with endogenous hyperkeratotic hand-foot eczema were included, aged 41 - 68 years, including 2 males and 3 females, with a disease duration ranging from 6 months to 40 years. For hand lesions, all five patients achieved HECSI50 at week 2, HECSI75 at week 12, and HECSI90 at week 20. For foot lesions, 4 patients achieved HECSI50 at week 4, and 4 patients achieved HECSI75 and HECSI90 at week 12. Conclusion Dupilumab could rapidly improve skin lesions in patients with endogenous hyperkeratotic hand-foot eczema who had an inadequate response to conventional therapies, with a favorable safety profile.

Key words: Biological agents, Eczema, Dupilumab, Endogenous hyperkeratotic hand eczema