ABSTRACT
A Type 2 lepra reaction or erythema nodosum leprosum is an anticipated complication in the lepromatous spectrum of leprosy cases. It is an example of an immune complex-mediated complement activated disease (Type III hypersensitivity reaction). Hence, we tried to target the inflammatory mediators and the mental stressors for the possible management strategies.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Erythema Nodosum/drug therapy , Inflammation Mediators/antagonists & inhibitors , Leprostatic Agents/therapeutic use , Leprosy, Lepromatous/drug therapy , Selective Serotonin Reuptake Inhibitors/therapeutic use , Stress, Psychological/drug therapy , Animals , Anti-Inflammatory Agents/adverse effects , Chronic Disease , Erythema Nodosum/diagnosis , Erythema Nodosum/metabolism , Erythema Nodosum/psychology , Humans , Inflammation Mediators/metabolism , Leprostatic Agents/adverse effects , Leprosy, Lepromatous/diagnosis , Leprosy, Lepromatous/metabolism , Leprosy, Lepromatous/psychology , Molecular Targeted Therapy , Recurrence , Selective Serotonin Reuptake Inhibitors/adverse effects , Stress, Psychological/metabolism , Stress, Psychological/psychologyABSTRACT
Acne, the most common skin disease, is a disorder of pilosebaceous units that affects adolescents mainly and adults occasionally. The pathogenesis is multifactorial. Besides genetic predisposition, other major factors include the action of androgens, pro-inflammatory lipids acting as ligands of peroxisome proliferator-activated receptors in the sebocytes, toll-like receptor-2 acting on keratinocytes, recognition of pathogen-associated molecular patterns, cytokines, chemokines, inflammasomes, neuroendocrine regulatory mechanisms, diet and other pro-inflammatory targets implicated in the activation of immune detection and response. Most of these factors converge on mammalian target of rapamycin complex1 (mTORC1) activation which is further enhanced by the nutrient signaling of Western diet. This multitude of pathogenic factors has led to a new armamentarium of drugs for the treatment of acne. Topical anti-androgens, insulin-like growth factor-1 inhibitors, peroxisome proliferator-activated receptor-modulators, acetylcholine inhibitors, topical retinoic acid metabolism-blocking agents, vitamin D analogues, antimicrobial peptides, interleukin-1α and interleukin-1ß blockers and immunotherapy are some of the novel treatment options.