USING TARGETED THERAPIES FOR INFLAMMATORY DERMATOSES
Targeted therapies continue to revolutionize the way we manage chronic inflammatory diseases in dermatology. In contrast to conventional immunosuppressive agents such as methotrexate, cyclosporine, and azathioprine, targeted therapies have the advantage of reducing inflammation to improve cutaneous disease while diminishing the concerns of cumulative end-organ toxicity. This has led to a paradigm shift from approaching disease management from a primarily as-needed basis to the goal of achieving continuous control. Nowhere in dermatology is this transformation more evident than in the treatment of psoriasis
Moderate-to-severe psoriasis often requires systemic treatments, including oral systemic therapies and biologics. An addition to the treatment repository for psoriasis is oral small molecules, which include apremilast, tofacitinib, and ponesimod.
Children who are recalcitrant to topical therapy for their moderate to severe plaque psoriasis and/or highly visible lesions may be candidates for systemic therapy.
With many new medications either on the market or currently being evaluated by the Food and Drug Administration, the purpose of this article is to review PsA for the dermatologist, to identify the current therapies that are available, and to help select which patients may benefit from these medications.
Moving beyond broadly immunosuppressive agents, newer therapies for AD offer more targeted immunomodulation in the forms of phosphodiesterase 4 inhibitors, Janus kinase inhibitors, and anticytokine monoclonal antibodies.