Cutis
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In the last few years, melanoma treatment has been revolutionized by the development of immune checkpoint-blocking antibodies or immune checkpoint inhibitors including ipilimumab, vemurafenib, dabrafenib, trametinib, nivolumab, and pembrolizumab. Although they have shown promising results, they also have caused multiple adverse events (AEs), particularly immune-related AEs (irAEs). Specialists should be familiar with these AEs.
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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered to be among the most severe dermatologic emergencies with high risk for morbidity and mortality if managed poorly. These disease processes usually are the result of a reaction to antipsychotic or antibiotic medications, though the complete list of potential causative drugs is extensive. ⋯ Over the last several years, reports advocating the benefits of cyclosporine, corticosteroids, and intravenous immunoglobulin (IVIG) have shown variable responses in their treatment of SJS/TEN. In this article, cyclosporine and its potential as an emerging therapeutic option for SJS/TEN patients is discussed.
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Postinflammatory hyperpigmentation (PIH) has posed a substantial challenge for patients with higher Fitzpatrick skin types, specifically types III to VI. Treatment modalities pose a number of limitations due to the number of treatments required, potential side effects, and overall efficacy. Fortunately, multiple therapies have been delineated that can be moderately to highly efficacious in treating PIH in patients with skin of color. This article will review some of these modalities and procedures for this common patient concern.
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Over the last decade, expanded understanding of psoriasis pathogenesis has led to the development of new systemic agents such as biological drugs that have revolutionized the treatment of psoriasis. Small molecule inhibitors also have been studied and offer patients options for oral administration. This article reviews recently approved and in-the-pipeline biologics (IL-17 inhibitors and IL-23 blockers) as well as small molecule inhibitors (phosphodiesterase 4 [PDE4] and Janus kinase [Jak] inhibitors).
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Psoriasis is a chronic debilitating disease in which dermatologists take a frontline role in improving the quality of life of affected patients. Although recent years have seen the advent of numerous new medications for the treatment of psoriasis, there still is considerable room for improvement in our treatment of this condition. ⋯ The upcoming systemic agents for the treatment of psoriasis are presented in this article, encompassing novel biologics and small-molecule medicines (eg, IL-17 receptor blockers, Janus kinase [Jak] inhibitors). The underlying mechanisms and currently available data for each drug will be discussed to impart a working knowledge of these new treatment options to dermatology residents, as these drugs may soon be added to our armamentarium for treating psoriasis.