In recent years major progress achieved in respect of the classic dermatological therapies practiced in the past millennium concerns the strong tendency to identify dermatological therapies not more general, but rather specific and targeted to a specific disease, or to particular manifestations of a disease, or to the particular characteristics assumed by the disease in individual patients.

These advances already cover a large group of diseases, first of all psoriasis, atopic dermatitis, some severe allergic diseases, the epithelial tumors of the skin and, especially, melanoma.

Skin CareThe achievements of scientific research have recently allowed, firstly, to develop some treatments admirably specific in the treatment of psoriasis. For example, some pharmacological agents, called “biological”, were, or are proving able to block some molecular pathways, clearly identified, can foster the development of the disease: these agents, such as “anti-TNF”, “anti-IL-12 / IL-23”, “anti-IL-17”, “anti-p-19”, they have already been determined, or are driving, formidable therapeutic results. I must confess, however, that personally I fear the possibility of occurrence of side effects, especially long-term, potentially achievable by agents able to cause such profound effects on biological molecular pathways so basic.

Regarding atopic dermatitis, while on the one hand you are waiting for the development of modern therapeutic agents to counter the defects caused by mutations of filaggrin and defects of the skin barrier, there is, paradoxically, on the other hand, a trend, countries where a shortage of dermatologists, to entrust atopic children in the care of nurses simple: this trend, however, is highly controversial and discussed.

Severe allergic diseases, such as the “toxic epidermal necrolysis”, will soon be treated “personalized”, based on a better characterization of the pathophysiological mechanisms involved in each case. Recently, however, it has reached a therapeutic success already using, in these cases, a traditional immunosuppressive therapy, such as cyclosporine.

The field of epithelial skin cancers is already experiencing significant therapeutic benefits following the recent use of biological agents “targeted”. For example, they were identified molecules able to block the most important molecular pathway that supports the development dell’epitelioma basal cell. Even more important, perhaps, is the identification of a “adjuvant” capable of inhibiting the specific mutation that maintains the onset of serious, albeit fortunately rare, “dermatofibrosarcoma protuberans”.

In the treatment of metastatic melanoma limited, to date, by the failure to which has met the chemotherapy treatments they are emerging certain promising drugs “targeted” against molecular alterations, genetically determined, against various molecular pathways “signal”. For example, specific inhibitors of a signal that can foster the development of mucosal melanoma and melanoma acrolentigginoso are achieving remarkable therapeutic success; Similarly, an inhibitor “chinosico” specific molecule oncogenic is proving valuable in treating the majority of patients carrying a mutation of the molecule. This, in our opinion, is only the dawn of an impending day for every patient with melanoma disease will be classified at the molecular level, in order to identify a therapy “targeted” case by case. For more tips visit


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