Significant developments in the use of mammalian target of rapamycin (mTOR) inhibitors (mTORIs) as immunosuppressant and antiproliferative agents have been made. Recent advances in the understanding ...of the mTOR signaling pathway and its downstream effects on tumorigenesis and vascular proliferation have broadened the clinical applications of mTORIs in many challenging disorders such as tuberous sclerosis complex, pachyonychia congenita, complex vascular anomalies, and inflammatory dermatoses. Systemic mTORI therapy has shown benefits in these areas, but is associated with significant side effects that sometimes necessitate drug holidays. To mitigate the side effects of systemic mTORIs for dermatologic applications, preliminary work to assess the potential of percutaneous therapy has been performed, and the evidence suggests that percutaneous delivery of mTORIs may allow for effective long-term therapy while avoiding systemic toxicities. Additional large placebo-controlled, double-blinded, randomized studies are needed to assess the efficacy, safety, duration, and tolerability of topical treatments. The objective of this review is to provide updated information on the novel use of mTORIs in the management of many cutaneous disorders.
A Subdermal Source: Contact Dermatitis Fogel, Alexander L., BS; Longmire, Michelle, MD; Rieger, Kerri E., MD, PhD ...
The American journal of medicine,
06/2015, Letnik:
128, Številka:
6
Journal Article
Recenzirano
Odprti dostop
A patient can be allergic to a new knee and such allergy is an often-overlooked complication of prosthetic implant surgery. Here, Fogel et al present their assessment, diagnosis and management of a ...60-year-old woman who presented to their dermatology clinic with a pruritic, crusted rash on her right knee. Eighteen months earlier, she had undergone a right knee replacement with an Evolution Medial-Pivot knee system. No complications occurred, and the patient had normal healing at the surgical site. Her past medical history was notable for conditions within the atopic diathesis, including severe asthma, sinusitis, postnasal drip, and a childhood history of eczema. In addition, she reported allergies to medications, including lisinopril and epineph rine. A review of systems was otherwise unrevealing.
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