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Stapokibart for Facial-Predominant AD-Like Dermatoses: A Retrospective Real-World Case Series Highlighting Response Heterogeneity

Zhu Y, Chen J, Wang P, Feng P, Wang X

Clinical, cosmetic and investigational dermatology, 2026

Abstract

Background: Facial-predominant inflammatory dermatoses are diagnostically heterogeneous and may overlap with atopic dermatitis (AD), contact dermatitis, rosacea-like inflammation, and autoimmune mimics. Stapokibart, an IL-4Rα-targeted monoclonal antibody, has demonstrated efficacy in moderate-to-severe AD, but real-world experience in facial-predominant AD-like presentations remains limited.

Methods: We retrospectively reviewed five unpublished patients with facial-predominant inflammatory dermatoses treated with stapokibart in routine practice. Clinical phenotype, diagnostic work-up, prior and concomitant therapy, dosing, symptom scores, treatment course, recurrence, and adverse events were summarized descriptively. The cohort was not intended as a diagnostically uniform efficacy population, and no formal hypothesis testing was performed.

Results: Five women aged 28-75 years were included. Pruritus numerical rating scale changed from a median of 3 (range, 2-4) at baseline to 1 (range, 0-3) at first follow-up; four patients improved and one worsened. All three patients with a well-supported facial-predominant AD phenotype showed rapid improvement in facial lesions and pruritus after stapokibart. One of these patients developed an injection-site reaction that led to treatment discontinuation; no serious adverse events were observed. One patient initially treated for AD-like facial dermatitis was subsequently evaluated for possible early clinically amyopathic dermatomyositis…

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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