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Seminars in Cutaneous Medicine and Surgery

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https://www.readbyqxmd.com/read/30215638/jak-stat-signaling-pathway-inhibition-a-role-for-treatment-of-various-dermatologic-diseases
#1
Jared Kahn, Sandhya Chowdary Deverapalli, David Rosmarin
Cutaneous inflammatory conditions such as psoriasis, atopic dermatitis, alopecia areata, vitiligo, and connective tissue diseases often remain a challenge to treat. Although there is an in-depth understanding of the clinical presentation of these diseases, much less is known regarding the pathophysiology. This has limited the effective treatment options for patients. A more detailed understanding of the pathogenesis of each disease will lead to newer targeted medications with less morbidity. Though there are different pathways involved in these diseases, the Janus Kinase (JAK)-Signal Transducer and Activator of Transcription proteins (STAT) signaling pathway is common to them all...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215637/novel-therapies-in-the-treatment-of-atopic-dermatitis
#2
Connie S Zhong, Sarina B Elmariah
Atopic dermatitis (AD) is a common cutaneous condition characterized by epidermal barrier disruption, severe skin inflammation, and pruritus. As a result of our growing understanding of disease pathogenesis, the therapeutic armamentarium to manage AD is rapidly expanding. 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. While such therapies are generally considered safer than traditional immunosuppressive agents that have been used off label for AD for decades, they are not without risk entirely...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215636/overview-and-update-on-biologic-therapy-for-moderate-to-severe-hidradenitis-suppurativa
#3
Martina L Porter, Nicole M Golbari, Stephen J Lockwood, Alexa B Kimball
Hidradenitis suppurativa (HS) is a frequently devastating inflammatory skin disorder. Although many treatments have been tried and tested to date, there is only one Food and Drug Administration-approved treatment option, adalimumab, which is currently indicated for moderateto- severe HS. Our understanding of the management of HS with biologic agents and with nonantibiotic and/ or antimicrobial systemic therapies continues to evolve. In this article, we summarize the existing data on biologics and other small-molecule systemic agents, as well as share our personal experiences with the pharmacological management of HS in the clinical setting...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215635/targeted-therapies-for-psoriatic-arthritis-an-update-for-the-dermatologist
#4
Scott A Elman, Michael Weinblatt, Joseph F Merola
Dermatologists are on the front line to identify psoriatic arthritis (PsA) in their patients with psoriasis. PsA is a prevalent and underdiagnosed disease with potential long-term complications and sequelae for patients. Targeted biologics have transformed the landscape of psoriasis and PsA therapy. These medications variably treat clinical manifestations of psoriatic disease: skin psoriasis, peripheral and axial arthritis, enthesitis, and nail disease. 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...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215634/targeted-therapies-for-pediatric-psoriasis
#5
Gene Schwartz, Amy S Paller
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. Methotrexate has been the most commonly used systemic agent in children. However, at least 25% of patients are now treated with biologics, especially tumor necrosis factor-α inhibitors, and their use is expanding as their availability, demonstrated safety and efficacy, and practitioner experience are increasing. In the United States, etanercept is Food and Drug Administration approved for ages 6 years and older and ustekinumab for 12 years of age and older...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215633/oral-small-molecules-for-psoriasis
#6
Sanminder Singh, April W Armstrong
Psoriasis is chronic inflammatory skin condition that imposes a significant physical and psychosocial burden on patients. 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. Of these 3 medications, only apremilast is currently approved for the treatment of psoriasis. Long-term safety data for apremilast suggest that it has a tolerable safety profile and leads to significant improvement in patients with psoriasis; however, there are few head-to-head comparisons with other oral systemic medications...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215632/il-23-inhibitors-for-moderate-to-severe-psoriasis
#7
Erin Ibler, Kenneth B Gordon
Since the identification of high levels of interleukin 23 (IL- 23) in psoriasis lesional skin, as well as finding that IL-23 was the most important source of the p40 subunit shared by IL-12 and IL-23, significant effort has been made in identifying potential new drugs that specifically block the unique IL-23 p19 subunit. At this time, 2 inhibitors of IL-23 p19 have been approved by the United States Food and Drug Administration, guselkumab and tildrakizumab. Two other agents, risankizumab and mirikizumab, have completed phase 3 and phase 2 of development, respectively...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215631/il-17-inhibitors-for-psoriasis
#8
So Yeon Paek, Jillian Frieder, Dario Kivelevitch, M Alan Menter
The role of the Th17/interleukin (IL)-23 pathway has been well elucidated in psoriasis. The IL-17 family includes 6 cytokines: IL-17A, IL-17B, IL-17C, IL-17D, IL-17E, and IL-17F. Two monoclonal antibodies targeting IL-17A (secukinumab, ixekizumab) and one antibody against the IL-17 receptor (brodalumab) have been approved for the treatment of moderate-to-severe plaque psoriasis. Clinical efficacy, safety, and tolerability of each agent is reviewed.
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215630/ustekinumab-for-the-treatment-of-psoriasis-an-evidence-update
#9
Zenas Zn Yiu, Richard B Warren
Ustekinumab is an interleukin-12/23 inhibitor used for the treatment of moderate-to-severe psoriasis. Here, we review new evidence since ustekinumab was licensed for relative efficacy in comparison with other biologic therapies from head-to-head randomized controlled trials and network meta-analyses for the treatment of psoriasis. We also review observational data emerging from psoriasis registries reporting the effectiveness and safety of ustekinumab. Overall, new evidence suggests that ustekinumab has a favorable balance between efficacy/effectiveness, safety, and tolerability and should remain a first-line biologic therapy option for patients with severe psoriasis at present...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215629/tnf-inhibitors-for-psoriasis
#10
Margot Chima, Mark Lebwohl
Tumor necrosis factor (TNF)-α has been identified as a key cytokine mediating cutaneous inflammation in the pathogenesis of psoriasis. The TNF inhibitors (TNFi's) infliximab, adalimumab, and etanercept are efficacious, Food and Drug Administration-approved medications for the treatment of moderate-to-severe plaque psoriasis. Each drug has a unique pharmacological profile that can have therapeutic implications when choosing a particular TNFi for a patient. An understanding of these idiosyncrasies can help guide therapeutic decisions for patients with psoriasis that also have inflammatory bowel disease, hepatitis C, hepatitis B, latent tuberculosis, obesity, cardiovascular disease, and heart failure...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30215628/using-targeted-therapies-for-inflammatory-dermatoses
#11
Jeffrey M Sobell
No abstract text is available yet for this article.
September 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30192346/treating-acne-in-patients-with-skin-of-color
#12
Andrew F Alexis, Julie C Harper, Linda F Stein Gold, Jerry K L Tan
Patients with skin of color are more likely to develop acne and postinflammatory hyperpigmentation (PIH). Many therapies for acne have demonstrated efficacy in darker skin types and in the treatment of PIH. Semin Cutan Med Surg 37(supp3):S71-S73 © 2018 published by Frontline Medical Communications.
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30192345/treating-acne-in-adult-women
#13
Julie C Harper, Linda F Stein Gold, Andrew F Alexis, Jerry K L Tan
Acne can persist into adulthood or erupt de novo at any point after adolescence. Adult acne is more common in women than in men. Considerations for treating acne in adult women include childbearing potential, pregnancy, lactation, and concomitant skin conditions. Semin Cutan Med Surg 37(supp3):S67-S70 © 2018 published by Frontline Medical Communications.
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30192344/advances-in-acne-and-rosacea-therapy
#14
Linda F Stein Gold, Andrew F Alexis, Julie C Harper, Jerry K L Tan
New topical therapies have demonstrated efficacy in patients with moderate or severe acne who might otherwise have required therapy with systemic antibiotics or isotretinoin. Increasing knowledge about the pathogenesis of acne has facilitated the development of therapies with novel modes of action. New and investigational therapies also are available or in development for the treatment of both the papulopustular and erythematous manifestations of rosacea. Semin Cutan Med Surg 37(supp3):S63-S66 © 2018 published by Frontline Medical Communications...
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30192343/current-concepts-in-acne-pathogenesis-pathways-to-inflammation
#15
Jerry K L Tan, Linda F Stein Gold, Andrew F Alexis, Julie C Harper
Acne is a disease of pilosebaceous inflammation. Pivotal in pathogenesis are the roles of hormones (insulin, insulin-like growth factor-1, androgens), Propionibacterium acnes, lipogenesis, and a proinflammatory lipid profile. Innate immune responses are induced through interaction with toll-like receptors and inflammasome activation initially and subsequently through adaptive immune activation. These insights into pathogenic inflammatory pathways can translate into novel therapeutic approaches for acne. Semin Cutan Med Surg 37(supp3):S60-S62 ©2018 published by Frontline Medical Communication...
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30192342/introduction
#16
Linda F Stein Gold
No abstract text is available yet for this article.
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30040090/immunotherapy-for-melanoma
#17
Lauren M Cuevas, Adil I Daud
Immunotherapy for the treatment of advanced melanoma has become a primary treatment in the clinic. Current therapies include systemic cytokines, immune checkpoint inhibitors, and localized intratumoral therapies. Checkpoint inhibitors block natural pathways that dampen or inhibit an immune response to stimulus. These pathways include programmed cell death 1 receptor/programmed death-ligand 1 and cytotoxic T lymphocyte antigen-4. Systemic immunotherapies have proven to be effective in clinical trials both as monotherapy and in combination therapy...
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30040089/biomarkers-for-immune-therapy-in-melanoma
#18
Douglas B Johnson, Jeewon Chon, Mark R Johnson, Justin M Balko
Immune checkpoint inhibitors have dramatically transformed melanoma treatment options. However, intrinsic and acquired resistance remain fundamental limitations to extending the benefits to all patients. Understanding molecular and clinical features that correlate with response to treatment (biomarkers) may unravel therapeutic resistance, assist in treatment decision-making, and facilitate drug development. An intensive effort to characterize these biomarkers is underway. Herein, we highlight promising molecular biomarkers involving the tumor microenvironment, host immune response, and microbiome...
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30040088/the-role-of-targeted-therapy-for-melanoma-in-the-immunotherapy-era
#19
Ryan J Sullivan
Over the past 10 years of remarkable development of both molecularly targeted and immune-targeted therapy for the treatment of melanoma, a clear preference of immunotherapy over molecularly targeted therapy has emerged among melanoma treatment providers. Still, the clinical data remain remarkable for patients with BRAF-mutant stage III and IV melanoma, and there seems to be a clear benefit of BRAF-targeted therapy for these patients. The key, then, is to identify the best way to use BRAF-targeted therapy. In this review, the clinical data of molecular-targeted therapy are summarized, mechanisms of resistance to single-agent BRAF and combined BRAF with mitogen-activated protein kinase/extracellular signal-regulated kinase (MEK) inhibitor are discussed, and strategies to overcome this resistance are presented; then, we review a number of clinical dilemmas that influence the decision-making of using targeted therapy over immunotherapy, and viceversa, and help define the specific role of targeted therapy in the immunotherapy era...
June 2018: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/30040087/adjuvant-therapy-for-resected-high-risk-melanoma
#20
Justin C Moser, Kenneth F Grossman
Melanoma is an aggressive cancer that arises from melanocytes that can both locally invade surrounding tissues as well as metastasize systemically. If detected early, melanoma can be curable with surgical resection. However, despite complete removal, high-risk resected melanomas have a significant rate of both local and distant recurrence. Curative treatment options are typically limited for patients who develop distant recurrence after resections of their primary melanoma. Therefore, adjuvant therapy is typically given after complete resection of high-risk melanomas to try and reduce the risk of recurrent disease...
June 2018: Seminars in Cutaneous Medicine and Surgery
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