Conclusions

This case underscores the importance of clinical awareness regarding vitiligo as a potential adverse effect of dupilumab therapy in patients with atopic dermatitis. Recognizing this complication early allows clinicians to reconsider biologic selection and pursue targeted topical treatment promptly, which may improve outcomes for affected patients. Our experience raises the hypothesis that topical JAK-STAT inhibition may offer a repigmentation benefit over calcineurin inhibition in this setting, though this observation is limited by the single-patient design and baseline asymmetry between treated sites, and should not be interpreted as demonstrating therapeutic superiority. Controlled, prospective studies with objective outcome measures are needed to evaluate this possibility. Continued clinician vigilance, prompt recognition, and individualized treatment planning remain essential when managing dupilumab-associated vitiligo. Larger, prospective studies are needed to validate these therapeutic approaches and to further clarify the underlying immunologic mechanisms driving this adverse effect, ultimately helping guide optimized, patient-centered care for individuals receiving biologic therapy for atopic dermatitis.