Cytokine-Mediated Molecular Pathophysiology of Hidradenitis Suppurativa: A Narrative Review.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory condition of the skin that mainly affects the apocrine gland-rich intertriginous areas. The disease manifests as painful nodules, abscesses, and pus-filled tunnels, which can severely impact patient's quality of life. While diagnosis is clinical, successful treatment options for this condition are limited. There has been an increase in research and clinical trials focusing on biomarkers and cytokines for clinical use. Understanding the potential biomarkers and cytokines implicated in HS pathogenesis may allow efficacious and safe treatment options. Summary: A literature review was conducted on nine biomarkers and cytokines. IL-1, IL-10, IL-17, IL-23, TNF-α, YKL-40, G-CSF, NOD2, and the complement system were identified due to their potential clinical utilization and pathophysiological involvement in HS. Key Messages: With further research expanding our understanding of the pathophysiology of HS and the roles these cytokines and biomarkers play, there is potential for utilization as diagnostic markers or development of antagonists against these specific agents for HS management.

The role of tralokinumab in the treatment of atopic dermatitis and future perspectives for adolescents.

Atopic dermatitis (AD) is an inflammatory skin disease that frequently occurs in adolescents. Although there are many treatment options, the challenge for clinicians is finding an effective long-term drug for AD with a favorable safety profile. The purpose of this review is to describe the role of tralokinumab, an IL-13 inhibitor, in treating adolescent AD. The clinical efficacy and safety of tralokinumab were established in clinical trials for adults with moderate-to-severe AD. Based on the results of these trials and the preliminary results of trials conducted on adolescents with AD, tralokinumab effectively alleviates symptoms with tolerable adverse effects. Extending the use of tralokinumab to adolescents with moderate-to-severe AD seems promising for the future.

Atopic dermatitis (AD) is a common long-term skin disease characterized by scaling, redness, itching, pain and sleep disturbances. Fortunately, many treatment options are available depending on the severity of the disease. In this article, the authors describe the potential role of tralokinumab, a drug that blocks a key signal in the immune system that causes AD. The results of recent studies and trials imply that tralokinumab can be effective in providing at least short-term relief of AD symptoms in patients unresponsive to other treatments. So far, it has had an acceptable overall safety profile. The future of tralokinumab treatment in the adolescent population seems promising.

The role of lebrikizumab in the treatment of atopic dermatitis in the adult population.

Although there are many atopic dermatitis (AD) treatments, finding a long-term medication with minimal side effects can be difficult. This review characterizes lebrikizumab as AD treatment in adults. A literature search was conducted to examine lebrikizumab's role in treating moderate to severe AD. In a phase III trial, 74% of adults with AD treated with lebrikizumab 250 mg every 4 weeks achieved an Investigator Global Assessment of 0/1, 79% achieved Eczema Area and Severity Index 75 and 79% experienced improvements in pruritus numeric rating scale scores relative to placebo. Common adverse effects in the ADvocate1 and ADvocate2 trials were conjunctivitis (7 and 8%, respectively), nasopharyngitis (4 and 5%, respectively) and headache (3 and 5%, respectively). Results from clinical trials suggest that lebrikizumab may be a viable alternative for AD management.

Atopic dermatitis, commonly known as eczema, has a big impact on people's lives. There are many treatments for eczema, with new ones becoming available. In this review, we discuss lebrikizumab as a treatment for moderate to severe eczema in adults. We performed a literature search to better understand lebrikizumab's role in treating eczema. In clinical trials, lebrikizumab reduced itchiness and improved rash in adults with moderate to severe eczema. The most reported side effects were pink eye (conjunctivitis), the common cold (nasopharyngitis) and headache. Lebrikizumab is effective in relieving eczema symptoms with tolerable side effects and could be an alternative treatment for adults with moderate to severe eczema.

Oral Tetracycline-Class Drugs in Dermatology: Impact of Food Intake on Absorption and Efficacy.

Tetracycline-class drugs are frequently used in dermatology for their anti-inflammatory properties to treat skin diseases such as acne, rosacea, and hidradenitis suppurativa (HS). The American Academy of Dermatology (AAD) clinical guidelines do not offer guidance regarding the co-administration of food with tetracycline-class drugs. The objectives of this study were to review the available evidence regarding whether taking tetracycline-class drugs with food decreases systemic absorption and is associated with an impact on clinical efficacy. A literature search was conducted using the PubMed database between February to May 2023 using the keywords "tetracycline-class drugs", "pharmacokinetics", "absorption", and "dermatology". Inclusion criteria included articles written in English and relevant to the absorption and efficacy of tetracycline-class drugs. This search yielded 131 articles written between 1977 to 2022, of which 29 met the criteria for review. United States Food and Drug Administration (FDA)-approved prescribing information for oral formulations of tetracycline, doxycycline, minocycline, and sarecycline were reviewed. Systemic absorption of tetracycline decreased when co-administered with food. Systemic absorption of oral doxycycline and minocycline was variable with food co-administration. The impact on bioavailability varied with the drug formulation and dosage. The absorption of oral sarecycline decreased when administered with food. Sarecycline is the only oral antibiotic where population pharmacokinetic studies demonstrated limited or no impact of food intake on clinical efficacy. There are no available data for other tetracycline-class drugs in dermatology. If patients find it more tolerable to take doxycycline, minocycline, and sarecycline with food to avoid gastrointestinal distress, this may merit consideration to encourage patient adherence. Since the impact of food intake on absorption varied with the dosage form of doxycycline and minocycline, consulting the appropriate package insert may give clinicians additional insight into differences in the various formulations.