Atopic dermatitis: a review of evolving targeted therapies.

INTRODUCTION: Atopic dermatitis (AD) is a chronic inflammatory skin condition, affecting a significant number of patients of all ages. As we learn more about the pathogenesis of AD, new targeted treatment options are being developed to better tailor its management. Currently, a variety of biologic agents are utilized to target specific components and regulators of the inflammatory pathways in allergic and inflammatory conditions. These targeted therapies allow for greater efficacy while limiting adverse effects. Areas covered: This review examines the current literature in respect to several different monoclonal antibodies that are being studied toward a personalized approach in the treatment of AD. Expert opinion: Several trials examining the use of biologics for AD have demonstrated mixed success. While some have shown promise for improvement of clinical symptoms, there are several barriers to support consistent use including cost, adverse effects, small sample sizes, conflicting evidence, and lack of demonstrated long-term safety and efficacy. The ultimate goal for future research is to develop biomarkers for different AD phenotypes in order to allow for targeted therapy of AD.

Temozolomide-induced Aplastic Anemia Treated with Eltrombopag and Granulocyte Colony Stimulating Factor: A Report of a Rare Complication.

Temozolomide is an alkylating agent used in the treatment for glioblastoma multiforme (GBM), the most frequent primary malignant brain tumor in adults. Temozolomide was approved in March 2005 for treatment of GBM, with the Stupp protocol (radiotherapy and concomitant use of temozolomide). Despite initial studies demonstrating mild and well-tolerated side effects, several recent reports describe severe hematologic adverse effects associated with temozolomide use. We report the case of a 51-year-old female diagnosed with GBM who received the standard treatment protocol of radiotherapy and concomitant temozolomide. The patient developed prolonged pancytopenia. Bone marrow biopsy demonstrated hypocellular bone marrow with diminished trilineage hematopoiesis, suggestive of drug-induced aplastic anemia. Although temozolomide is regarded as a safe drug with few side effects, severe hematologic toxicities have been reported.

Angiosarcoma with Synchronous Cutaneous and Small Bowel Involvement: A Report of a Rare Presentation.

Angiosarcomas are mesenchymal neoplasms of vascular origin that represent approximately 2% of soft tissue sarcomas. We discuss the case of a 75-year-old female who had presented with a purple nodular rash along the bilateral nasolabial folds. Upon further work-up, she was diagnosed with angiosarcoma, with the confirmed involvement of multi-focal sites. These included biopsy proven sites of the face and duodenum along with the radiographic involvement of the lungs, liver, and osseous tissue. We report this unique presentation of a rare malignancy and the treatment course with radiation, paclitaxel, and bevacizumab. We also discuss the implications of her co-morbid liver cirrhosis and gastric antral vascular ectasia (GAVE) in terms of its influence on the development of the angiosarcoma and treatment response.