Inflammatory Skin Diseases in Immunosuppressed Patients: Biologics & Small Molecule Inhibitors

The presentation focuses on treatments for inflammatory skin diseases in immunosuppressed patients, particularly organ transplant recipients. Biologics and small molecule inhibitors are explored, emphasizing their safety and effectiveness in this vulnerable population where traditional treatments may pose risks. The speaker acknowledges a lack of extensive data, as clinical trials often exclude transplant patients, resulting in reliance on case reports and limited studies. Psoriasis management recommendations suggest starting with acitretin or increasing anti-rejection drug doses if needed, while TNF-alpha inhibitors show mixed outcomes regarding infection risks. IL-23 and IL-17 inhibitors appear promising but have specific concerns in lung transplant recipients due to heightened risk of severe infections. Atopic dermatitis treatments like dupilumab are discussed, with caution advised regarding potential heart failure risks in patients with ischemic heart disease. JAK inhibitors raise significant concerns regarding viral reactivation, requiring close monitoring. Overall, the speaker urges careful selection of patients for these advanced therapies, thorough discussions with transplant teams, and encourages data reporting to improve understanding of these treatments in transplant recipients.