Drug management of neutrophilic dermatoses

Simone Garcovich, Clara De Simone, Emilio Berti, Angelo Valerio Marzano

Research output: Contribution to journalReview article

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.

Original languageEnglish
Pages (from-to)1119-1128
Number of pages10
JournalExpert Review of Clinical Pharmacology
Volume10
Issue number10
DOIs
Publication statusPublished - Oct 3 2017

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Keywords

  • autoinflammation
  • IL-1
  • IL-17
  • neutrophil
  • neutrophilic dermatosis
  • PAPA syndrome
  • Pyoderma gangrenosum
  • subcorneal pustular dermatoses
  • Sweet syndrome
  • therapeutics
  • TNF-alpha

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)

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