Continued psoriasis research has led to a translational revolution in inflammatory skin diseases. As a result, there are now a number of safer and more effective medications that can address a growing list of common immune-mediated skin diseases, such as atopic dermatitis, alopecia areata, vitiligo, hidradenitis suppurativa, acne, and rosacea.
The treatment of inflammatory skin diseases of late has been advanced due to a better understanding in the mechanics of the individual disease. Continued research and development of therapeutic avenues for psoriasis has led to a translational revolution, the lessons of which can now also be observed in other common inflammatory diseases such as atopic dermatitis, alopecia areata, vitiligo, hidradenitis suppurativa, acne, and rosacea. According to one expert, the journey has been arduous but the future is bright for patients with inflammatory skin diseases mostly due to the years-long work on psoriasis.
Atopic dermatitis and psoriasis are inflammatory skin diseases characterized by immune-mediated inflammation and abnormal keratinocyte differentiation and although their T-cell infiltration characterizes both diseases, T-cell polarization differs. Because of their similarities, however, the therapeutics for atopic dermatitis in particular has shown to benefit from continued psoriasis research.
“It took decades for us to get from relatively primitive treatments of psoriasis to the very advanced perfected treatments that we currently have available, and we can clear almost everybody with these therapies. The advent of the biologics around the turn of the century has changed the treatment and management of inflammatory skin diseases forever,” said Mark Lebwohl MD, FAAD, Sol and Clara Kest Professor and Chairman of the Department of Dermatology at the Mount Sinai School of Medicine, New York, New York.
Cyclosporine worked well but it basically knocked out the whole immune system, Dr. Lebwohl said, making patients more susceptible to an increase in cancers, opportunistic infections, as well as a host of other side effects. Current advanced treatment approaches include targeted therapies that target individual molecules in the immune system and lead to the clearing of inflammatory skin diseases that are immunologically mediated, without disrupting the whole immune system.
“The first biologics like alefacept were only modestly effective and they targeted the activation of lymphocytes. These agents were designed to target just a tiny fraction of the immune system, which ultimately allowed us to treat psoriasis much more effectively,” Dr. Lebwohl said.
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