Atopic dermatitis (AD) is a prevalent inflammatory skin condition that, depending on its severity, can cause enormous morbidity. Corticosteroids and systemic immunosuppression, traditionally standard of care for difficult-to-treat disease, have many undesirable side effects. The desire for targeted treatments along with an improved understanding of the pathophysiology of AD has spurred the development of novel treatments. In this article, we review promising new treatments and discuss how their targets-IL-13, IL-31, OX40 (CD134), and the Janus kinase family of proteins-participate in the pathogenesis of AD. We review the published phase II and III data for dupilumab, tralokinumab, lebrikizumab, nemolizumab, anti-OX40 antibody, baricitinib, abrocitinib, and upadacitinib. The introduction of new agents may offer new options, but it remains to be seen how narrow-acting agents, like single interleukin inhibitors, will compare in safety and efficacy to broad-acting agents such as JAK inhibitors. Key Points Our better understanding of the pathophysiology of AD has resulted in an explosion of research into new immunotherapies for this patient population. Multiple new agents targeting IL-13, IL-31, OX40 (CD134), and Janus kinase proteins may be effective for AD.
Purpose The human arterial wall is smaller than the spatial resolution of current positron emission tomographs. Therefore, partial volume effects should be considered when quantifying arterial wall 18 F-FDG uptake. We evaluated the impact of a novel method for partial volume effect (PVE) correction with contrast-enhanced CT (CECT) assistance on quantification of arterial wall 18 F-FDG uptake at different imaging timepoints. Methods Ten subjects were assessed by CECT imaging and dual time-point PET/CT imaging at approximately 60 and 180 min after 18 F-FDG administration. For both time-points, uptake of 18 F-FDG was determined in the aortic wall by calculating the blood pool-corrected maximum standardized uptake value (cSUV MAX ) and cSUV MEAN
Background: Systemic methotrexate (MTX) is a useful treatment for many dermatologic conditions, however, the risk of adverse events prevents its use in patients with minimal or localized disease. Topical application of MTX may be an option to avoid the systemic adverse effects of oral MTX.
Objective:To assess what is known about the efficacy and safety of topical methotrexate.Methods: A search on Pubmed was conducted. There were no limits on publication date.Results: A total of 963 articles were discovered. Using our exclusion criteria, 916 articles were excluded; 47 articles were used for full text assessment. Topical MTX has been used primarily in psoriasis but also in mycosis fungoides, lymphomatoid papulosis, and oral precancerous lesions.Optimal delivery system and formulation for adequate penetration is still under investigation.
Conclusion:The quality of evidence for the utility of topical methotrexate in psoriasis is good, however, for other dermatologic diseases, the quality is poor. Topical MTX with improved delivery methods may be a viable tool against certain localized dermatologic conditions for patients who do not tolerate oral MTX. Further double-blinded randomized controled studies are needed to substantiate the utility of topical methotrexate.
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