Role of Topical Therapies in the Management of Cutaneous Disease

Abstract

Within the last decade, healthcare providers have had a larger selection of effective novel topical immunomodulatory agents to treat many dermatologic conditions. Novel mechanisms of action of newer topical agents have facilitated differentiation from well-established topical agents such as corticosteroids and 5-fluorouracil. Further, because of a growing understanding of the immune mechanisms within the skin, the opportunity has arisen to use the body's immune system to effectively treat many dermatologic conditions, such as condyloma acuminata, actinic keratosis, basal cell carcinoma, and atopic dermatitis, while maintaining a favorable safety profile. Imiquimod 5% cream, an immune response modifier, is safe and effective in the treatment of condyloma acuminata, actinic keratosis, and primary superficial basal cell carcinoma (sBCC). Pimecrolimus cream 1% and tacrolimus ointment (0.1% and 0.03%) are safe and effective in the treatment of atopic dermatitis. This review highlights newer data on approved and investigational indications for these topical immunomodulatory agents.

Toll-like Receptors 3 and 7 Agonists Enhance Tumor Cell Lysis by Human γδ T Cells

“…The treatment of tumor cells with poly(I:C) upregulated CD54, and imiquimod downregulated MHC class I molecules. To date, imiquimod is used as first line topical therapy for, e.g., genital condyloma, actinic keratosis, and basal cell carcinomas (43). Our data raise a note of caution with regard to a possible in vivo application of poly (I:C) or imiquimod (except for topical application) due to (a) additional side effects described by others (44) including poly(I:C)-induced shock, renal failure, and hypersensitivity reactions; (b) enhanced survival in the majority of the tested tumor cells (except of Colo357); (c) no enhancing effect on costimulatory molecules; and (d) insufficient examination of effects on other TLR3-or TLR7-expressing cells of the innate and adaptive immune system.…”

Toll-Like Receptors: Role in Dermatological Disease

“…This prevents nuclear translocation of (NFAT nuclear factor of activated T cells), thereby inhibiting the synthesis of pro-inflammatory cytokines in T cells [104, 171]. Pimecrolimus and tacrolimus are ascomycin macrolactam derivatives that are categorised as inhibitors of calcium-dependent phosphatase.…”

“…Pimecrolimus and tacrolimus are ascomycin macrolactam derivatives that are categorised as inhibitors of calcium-dependent phosphatase. In the early stages of AD, the topical application of 1% pimecrolimus was deemed more effective than topical steroids [102, 171]. Different formulations of the drug are being tested for efficacy in psoriasis, vitiligo, and other skin diseases [127, 171, 180].…”

Effects of Magnetic Infrared Laser on Dinitrofluorobenzene-induced Contact Dermatitis in Mice

“…When the surface of the skin is inflamed, cracked or raw, initial application of DNFB induces stinging or burning sensations. This irritation would lessen as the allergic dermatitis improves together with anti-inflammatory activity 20,21) . In the present study, the effects of MIL on DNFB-induced contact dermatitis were monitored and compared with 15 mg/kg dexamethasone, intraperitoneal treatment, according to previous methods 22) .…”