Ablative fractional lasers (AFXL) enhance uptake of therapeutics and this newly emerging field is called laser-assisted drug delivery (LAD). This new science has emerged over the past decade and is finding its way into clinical practice. LAD is poised to change how medicine delivers drugs. Topical and systemic application of pharmaceutical agents for therapeutic effect is an integral part of medicine. With topical therapy, the stratum corneum barrier of the skin impairs the ability of drugs to enter the body. The purpose of LAD is to alter the stratum corneum, epidermis, and dermis to facilitate increased penetration of a drug, device, or cell to its respected target. AFXL represents an innovative, non-invasive strategy to overcome the epidermal barrier. LAD employs three steps: (1) breakdown of the skin barrier with a laser, (2) optional use a laser for a therapeutic effect, (3) delivery of the medicine through laser channels to further enhance the therapeutic effect. The advantages of using lasers for drug delivery include the ease of accessibility, the non-invasive aspect, and its effectiveness. By changing the laser settings, one may use LAD to have a drug remain locally within the skin or to have systemic delivery. Many drugs are not intended for use in the dermis and so it has yet to be determined which drugs are appropriate for this technique. It appears this developing technology has the ability to be a new delivery system for both localized and systemic delivery of drugs, cells, and other molecules. With responsible development AFXL-assisted drug delivery may become a new important part of medicine.

Overall, the present data demonstrate that acute interactions of nicotine and other psychomotor stimulants produce potentiative effects and that these transient interactions may play a role in the frequent co-use and abuse of nicotine and other stimulants.

Psoriasis is a chronic inflammatory disease estimated to affect 1%-3% of the worldwide population. It is not simply a cutaneous disease but also poses a significant medical, social, and economic burden worldwide. Tumor necrosis factor (TNF)-α inhibitors are currently amongst the most important drugs in the therapeutic management of psoriasis. Patients using TNF-α inhibitors are at risk for infections including active and latent tuberculosis. Adalimumab, one of the TNF-α inhibitors, is a fully human monoclonal antibody that received approval for the treatment of chronic plaque psoriasis in 2008. Its use has been studied extensively for its safety and efficacy profile in the clinical setting. For the purpose of this review, we accessed the major publications in English relating to the use of adalimumab for psoriasis. Adalimumab appears to be one of the most efficacious biologic agents for the treatment of psoriasis. Results from various clinical trials including the REVEAL, CHAMPION, and BELIEVE are included in this review. The most recent data from an ongoing post-marketing study (ESPRIT) is also included in the analysis. Research regarding the safety, efficacy, and patient-reported outcomes support a favorable risk-benefit profile for adalimumab.

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