Frontiers in Medicine (Jun 2022)
Unmet Medical Needs in Chronic, Non-communicable Inflammatory Skin Diseases
- Hideyuki Ujiie,
- David Rosmarin,
- Michael P. Schön,
- Michael P. Schön,
- Sonja Ständer,
- Katharina Boch,
- Martin Metz,
- Martin Metz,
- Marcus Maurer,
- Marcus Maurer,
- Diamant Thaci,
- Enno Schmidt,
- Enno Schmidt,
- Connor Cole,
- Connor Cole,
- Kyle T. Amber,
- Kyle T. Amber,
- Dario Didona,
- Michael Hertl,
- Andreas Recke,
- Hanna Graßhoff,
- Alexander Hackel,
- Anja Schumann,
- Gabriela Riemekasten,
- Katja Bieber,
- Gant Sprow,
- Gant Sprow,
- Joshua Dan,
- Joshua Dan,
- Detlef Zillikens,
- Tanya Sezin,
- Angela M. Christiano,
- Kerstin Wolk,
- Kerstin Wolk,
- Robert Sabat,
- Robert Sabat,
- Khalaf Kridin,
- Khalaf Kridin,
- Victoria P. Werth,
- Victoria P. Werth,
- Ralf J. Ludwig,
- Ralf J. Ludwig
Affiliations
- Hideyuki Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- David Rosmarin
- Department of Dermatology, Tufts Medical Center, Boston, MA, United States
- Michael P. Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
- Michael P. Schön
- Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
- Sonja Ständer
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Muenster, Muenster, Germany
- Katharina Boch
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Martin Metz
- Institute for Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Martin Metz
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany
- Marcus Maurer
- Institute for Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Marcus Maurer
- Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany
- Diamant Thaci
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
- Enno Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Enno Schmidt
- 0Lübeck Institute of Experimental Dermatology and Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
- Connor Cole
- 1Division of Dermatology, Rush University Medical Center, Chicago, IL, United States
- Connor Cole
- 2Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
- Kyle T. Amber
- 1Division of Dermatology, Rush University Medical Center, Chicago, IL, United States
- Kyle T. Amber
- 2Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
- Dario Didona
- 3Department of Dermatology and Allergology, Philipps-Universität, Marburg, Germany
- Michael Hertl
- 3Department of Dermatology and Allergology, Philipps-Universität, Marburg, Germany
- Andreas Recke
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Hanna Graßhoff
- 4Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
- Alexander Hackel
- 4Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
- Anja Schumann
- 4Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
- Gabriela Riemekasten
- 4Department of Rheumatology and Clinical Immunology, University of Lübeck, Lübeck, Germany
- Katja Bieber
- 0Lübeck Institute of Experimental Dermatology and Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
- Gant Sprow
- 5Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Gant Sprow
- 6Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
- Joshua Dan
- 5Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Joshua Dan
- 6Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
- Detlef Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Tanya Sezin
- 7Department of Dermatology, Columbia University Medical Center, New York, NY, United States
- Angela M. Christiano
- 7Department of Dermatology, Columbia University Medical Center, New York, NY, United States
- Kerstin Wolk
- 8Psoriasis Research and Treatment Centre, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Kerstin Wolk
- 9Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Robert Sabat
- 8Psoriasis Research and Treatment Centre, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Robert Sabat
- 9Interdisciplinary Group Molecular Immunopathology, Dermatology/Medical Immunology, Charité—Universitätsmedizin Berlin, Berlin, Germany
- Khalaf Kridin
- 0Lübeck Institute of Experimental Dermatology and Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
- Khalaf Kridin
- 0Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Victoria P. Werth
- 5Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Victoria P. Werth
- 6Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
- Ralf J. Ludwig
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Ralf J. Ludwig
- 0Lübeck Institute of Experimental Dermatology and Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
- DOI
- https://doi.org/10.3389/fmed.2022.875492
- Journal volume & issue
-
Vol. 9
Abstract
An estimated 20–25% of the population is affected by chronic, non-communicable inflammatory skin diseases. Chronic skin inflammation has many causes. Among the most frequent chronic inflammatory skin diseases are atopic dermatitis, psoriasis, urticaria, lichen planus, and hidradenitis suppurativa, driven by a complex interplay of genetics and environmental factors. Autoimmunity is another important cause of chronic skin inflammation. The autoimmune response may be mainly T cell driven, such as in alopecia areata or vitiligo, or B cell driven in chronic spontaneous urticaria, pemphigus and pemphigoid diseases. Rare causes of chronic skin inflammation are autoinflammatory diseases, or rheumatic diseases, such as cutaneous lupus erythematosus or dermatomyositis. Whilst we have seen a significant improvement in diagnosis and treatment, several challenges remain. Especially for rarer causes of chronic skin inflammation, early diagnosis is often missed because of low awareness and lack of diagnostics. Systemic immunosuppression is the treatment of choice for almost all of these diseases. Adverse events due to immunosuppression, insufficient therapeutic responses and relapses remain a challenge. For atopic dermatitis and psoriasis, a broad spectrum of innovative treatments has been developed. However, treatment responses cannot be predicted so far. Hence, development of (bio)markers allowing selection of specific medications for individual patients is needed. Given the encouraging developments during the past years, we envision that many of these challenges in the diagnosis and treatment of chronic inflammatory skin diseases will be thoroughly addressed in the future.
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