Drug management of neutrophilic dermatoses. Issue 10 (3rd October 2017)

• Record Type: Journal Article
• Authors: Garcovich, Simone; De Simone, Clara; Berti, Emilio; Marzano, Angelo Valerio
• Is Part Of: Expert review of clinical pharmacology. Volume 10:Issue 10(2017)
• Page Start: 1119
• Page End: 1128
• Publication Date: 2017-10-03
• Subjects: Pyoderma gangrenosum -- Sweet syndrome -- neutrophilic dermatosis -- subcorneal pustular dermatoses -- therapeutics -- PAPA syndrome -- autoinflammation -- IL-1 -- TNF-alpha -- IL-17 -- neutrophil; Clinical pharmacology -- Periodicals; 615.105
• DOI: 10.1080/17512433.2017.1356719
• Languages: English
• ISSNs: 1751-2433

Abstract

ABSTRACT: Introduction : Neutrophilic dermatoses are a heterogenous group of chronic, cutaneous inflammatory conditions characterized by the accumulation of neutrophils in the skin and by systemic inflammation. Neutrophilic dermatoses can be idiopathic or associated with other inflammatory or systemic diseases, including the group of the hereditary, autoinflammatory syndromes. Clinical management is challenging, due to limited clinical evidence and lack of clinical practice guidelines. Areas covered : This review provides an overview of current therapeutic management of the three prototypical neutrophilic dermatoses, aseptic pustulosis of the folds, Sweet syndrome and pyoderma gangrenosum. In addition, we describe innovative, pathogenesis-oriented treatment approaches, which are based on recent advances in the pathophysiology of neutrophilic dermatoses and autoinflammatory syndromes. The increasing role of the IL-1 cytokine family in initiating neutrophilic inflammation in both idiopathic and syndromic disease opened the way for the use of targeted biological treatment. Another promising treatment strategy is aimed at blocking downstream effector cytokines, such as IL12/23 and IL-17, involved in the autoinflammatory immune cascade. Expert commentary : In chronic-recurrent and syndromic cases of neutrophilic dermatoses, there is an unmet clinical need for long-term, continuous disease control. Future controlled clinical studies will optimize the use of targeted-biological agents in sequential or combination treatment strategies.