PMID- 36121579
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220930
IS  - 2193-8210 (Print)
IS  - 2190-9172 (Electronic)
VI  - 12
IP  - 10
DP  - 2022 Oct
TI  - Dermatologic Disease-Directed Targeted Therapy (D(3)T(2)): The Application of 
      Biomarker-Based Precision Medicine for the Personalized Treatment of Skin 
      Conditions-Precision Dermatology.
PG  - 2249-2271
LID - 10.1007/s13555-022-00801-2 [doi]
AB  - Precision dermatology uses individualized dermatologic disease-directed targeted 
      therapy (D(3)T(2)) for the management of dermatoses and for the evaluation and 
      therapy of cutaneous malignancies. Personalized/precision strategies are based on 
      biomarkers that are most frequently derived from tissue transcriptomic expression 
      or genomic sequencing or from circulating cytokines. For instance, the pathologic 
      diagnosis of a pigmented lesion and determining the prognosis of a malignant 
      melanocytic neoplasm can be enhanced by genomic/transcriptomic analysis. In 
      addition to biopsy, innovative techniques have been developed for obtaining 
      transcriptomes in skin conditions; as an example, patches can be applied to a 
      psoriasis plaque for a few minutes to capture the epidermis/upper dermis 
      transcriptome. Atopic dermatitis and prurigo nodularis may also be candidate 
      conditions for precision dermatology. Precision dermatology has a role in 
      managing melanoma and nonmelanoma skin cancers and rare cutaneous tumors-such as 
      perivascular epithelioid cell tumor (PEComa)-that can originate in or metastasize 
      to the skin. For instance, advanced/metastatic basal cell carcinomas can be 
      treated with Hedgehog inhibitors (vismodegib and sonidegib) targeting the 
      smoothened (SMO) or patched 1 (PTCH1) gene alterations that are a hallmark of 
      these cancers and activate the Hedgehog pathway. Advanced/metastatic basal and 
      cutaneous squamous cell cancers often have a high tumor mutational burden (which 
      predicts immunotherapy response); immune checkpoint blockade with cemiplimab, a 
      programmed cell death protein 1 (PD1) inhibitor, is now approved for these 
      malignancies. Gene expression profiling of primary cutaneous squamous cell 
      carcinoma can identify those individuals at high risk for subsequent metastases. 
      In the realm of rare neoplasms, PEComas-which can originate in the skin, albeit 
      uncommonly-have tuberous sclerosis complex 1 (TSC1)/tuberous sclerosis complex 2 
      (TSC2) gene alterations, which activate mammalian target of rapamycin (mTOR) 
      signaling, and can be suppressed by nab-sirolimus, now approved for this 
      condition. In summary, precision dermatologic techniques/strategies are an 
      important emerging approach for evaluation and management of skin disorders and 
      cutaneous neoplasms, and may serve as a paradigm for the application of precision 
      medicine beyond dermatology.
CI  - (c) 2022. The Author(s).
FAU - Cohen, Philip R
AU  - Cohen PR
AD  - Department of Dermatology, Davis Medical Center, University of California, 
      Sacramento, CA, USA. mitehead@gmail.com.
AD  - Touro University California College of Osteopathic Medicine, Vallejo, CA, USA. 
      mitehead@gmail.com.
AD  - University of California, 10991 Twinleaf Court, San Diego, CA, 92131, USA. 
      mitehead@gmail.com.
FAU - Kurzrock, Razelle
AU  - Kurzrock R
AD  - Department of Medicine, Medical College of Wisconsin Cancer Center and Genome 
      Sciences and Precision Medicine Center, Milwaukee, WI, USA.
AD  - Worldwide Innovative Network (WIN) for Personalized Cancer Therapy, Villejuif, 
      France.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220919
PL  - Switzerland
TA  - Dermatol Ther (Heidelb)
JT  - Dermatology and therapy
JID - 101590450
PMC - PMC9515268
OTO - NOTNLM
OT  - Atopic dermatitis
OT  - Basal cell carcinoma
OT  - Melanoma
OT  - Perivascular epithelioid cell tumor
OT  - Precision dermatology
OT  - Precision medicine
OT  - Prurigo nodularis
OT  - Psoriasis
OT  - Squamous cell carcinoma
OT  - Targeted therapy
EDAT- 2022/09/20 06:00
MHDA- 2022/09/20 06:01
PMCR- 2022/09/19
CRDT- 2022/09/19 11:19
PHST- 2022/08/04 00:00 [received]
PHST- 2022/08/23 00:00 [accepted]
PHST- 2022/09/20 06:00 [pubmed]
PHST- 2022/09/20 06:01 [medline]
PHST- 2022/09/19 11:19 [entrez]
PHST- 2022/09/19 00:00 [pmc-release]
AID - 10.1007/s13555-022-00801-2 [pii]
AID - 801 [pii]
AID - 10.1007/s13555-022-00801-2 [doi]
PST - ppublish
SO  - Dermatol Ther (Heidelb). 2022 Oct;12(10):2249-2271. doi: 
      10.1007/s13555-022-00801-2. Epub 2022 Sep 19.