Prior case reports of eosinophilic dermatoses treated with mepolizumab all featured peripheral eosinophilia, and one case report of chronic spontaneous urticaria treated with mepolizumab was in a patient with eosinophilic asthma.2, 3, 4,10 We report the successful treatment of an unspecified eosinophilic dermatosis with mepolizumab, highlighting a potential role for anti-IL-5 biologics in eosinophil-driven skin diseases, regardless of a peripheral eosinophilia background. Here, IL5 is linked to Increased total eosinophil count.