Dermatologic Disease-Directed Targeted Therapy (D3T2): The Application of Biomarker-Based Precision Medicine for the Personalized Treatment of Skin Conditions—Precision Dermatology

Abstract

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

Basal cell carcinoma in situ of the skin revisited: case reports of the superficial type and fibroepithelioma type of this in situ cutaneous neoplasm

“…They appeared as scaly erythematous plaques on the abdomen or back; microscopic examination showed superficial extension of basaloid tumor cells-that were contiguous with the overlying epidermis-into the papillary dermis [32]. This tumor has generally been referred to as a superficial basal cell carcinoma [5,6,[37][38][39][40][41][42][43].…”

“…Squamous cell carcinoma, malignant melanoma, and Merkel cell carcinoma are invasive cutaneous tumors [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. In contrast, in situ variants of these malignancies are characterized by neoplasms in which tumor cells are restricted to the epidermis [3,7,8,[18][19][20][21][22][23][24][25][26][27][28][29][30][31].…”

Clinical Utility of the 31-Gene Expression Profile Test on the Management of Cutaneous Melanoma by Nurse Practitioners and Physician Assistants

“…Across cancer types, GEP testing has demonstrated value as a risk-stratification tool for physicians and health-care providers to guide treatment and surveillance planning for patients ( Sun et al, 2021 ; Hijazo-Pechero et al, 2021 ; Cohen & Kurzrock, 2022 ; Farberg et al, 2017 ; Mirsky et al, 2018 ; Chandler et al, 2018 ; Ward et al, 2013 ; Xin et al, 2017 ). Although most patients with stage I or II tumors have a good prognosis and will not experience recurrence, many will still have poor outcomes ( Gershenwald et al, 2017 ; Morton et al, 2014 ).…”

“…Molecular-based technologies for predicting outcomes have received increasing interest and are commonly used in breast cancer, uveal melanoma, and other diseases to improve patient care ( Sun et al, 2021 ; Hijazo-Pechero et al, 2021 ; Field & Harbour, 2014 ). Moreover, there is growing interest in molecular risk stratification in CM using gene expression tests that provide prognostic information ( Cohen & Kurzrock, 2022 ; Bollard et al, 2021 ), including the 31-gene expression profile test (31-GEP; Castle Biosciences, Inc., Friendswood, Texas), which provides prognostic information independent of other clinical and pathological factors by analyzing differential gene expression of a validated panel of 31 gene targets ( Gerami et al, 2015a , 2015b ). The 31-GEP provides a continuous probability score between zero and one to stratify a patient's risk of recurrence or metastasis.…”

A Group Contribution Analogy as Selection Criteria for Nutrients Fermentation Media in the Production of Tacrolimus, Sirolimus and Ascomycin

“…However, this use was abandoned when it was discovered to have potent immunosuppressive and antiproliferative properties due to its ability to inhibit mTOR [13]. Sirolimus also acts in the treatment of dermatologic disease [14], diabetes [15] and, H1N1 [16] and H5N6 virus [17 and limitations of mTOR inhibitors in the treatment of cancer [18]. NO 12 , also called Immunomycin, FR-900520, FK520, is an ethyl analog of tacrolimus (FK506) with strong immunosuppressant properties.…”