Would a combined treatment help manage asthma and eczema?

Question

Hello doctor,

My husband is 43 and has had atopic dermatitis since childhood. Six years ago, he was diagnosed with moderate persistent asthma. His doctor recently prescribed Montelukast and a Fluticasone inhaler to help manage his asthma. However, it feels like his asthma and skin condition have not been considered together in one treatment plan.

We have noticed that his skin flares often get worse when his asthma symptoms do, and the same happens the other way around. Last month, his eosinophil count was 620 cells/µL, which his doctor said was a bit high. At the moment, his atopic dermatitis affects his torso and arms. He uses betamethasone valerate during flare-ups, but it is not working as well as before.

His lung doctor recently mentioned Dupilumab as a possible treatment for his asthma, but was not sure if a dermatologist should be involved in this decision. I have read that atopic dermatitis and asthma can be connected.

I am curious if a combined treatment plan could help manage both better. We have also noticed that some food triggers, especially dairy and some nuts, appear to worsen his skin and breathing symptoms simultaneously.

Will a combination treatment plan help him?
Also, could Dupilumab be used for his atopic dermatitis and asthma at the same time?
Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern.

What you're describing is pretty common for people who have had allergies for a long time. His asthma and his atopic dermatitis go together because they are both expressions of the same allergic tendency in his body. This link can last well into adulthood, which is why his breathing problems and skin flare-ups often worsen together.

His eosinophil count was 620 cells/µL, which also fits this pattern, showing that his body has an increased allergic or inflammatory response. Treating each condition separately, like using inhalers for asthma or creams for the skin, often doesn’t work as well, which seems to be the issue right now.

A combined treatment plan is the best approach and is actually recommended. Ideally, his lung and skin doctors should work together to treat the underlying allergy, instead of handling each problem on its own.

Dupilumab could be a good option for your husband. It works on the allergic pathway and is approved for both moderate-to-severe atopic dermatitis and asthma with high eosinophil levels. Many people with similar issues have seen improvements in both breathing and skin symptoms, especially when other treatments haven’t worked well enough. At 43, he is definitely eligible for this treatment, since age does not limit its use. What matters most is his medical situation.

Foods like dairy and some nuts can make both skin and breathing symptoms worse. However, these foods usually trigger symptoms rather than cause the underlying problem. Avoiding them can help reduce flare-ups, but it should be used along with proper medical treatment for the inflammation.

At this point, his lung and skin doctors should work together to decide if starting Dupilumab is right for him. This way, he can have a treatment plan that covers both conditions.

I hope this addresses your concerns.

Please feel free to follow up if you need any additional clarification.

Thank you.