In the dermatological treatment onsite various kinds of ointments have been applied
to the lesional skin of the patients as a matter of routine, for the provision of antibacterial
or antiviral activity at the locale, the promotion of anti-inflammatory effect, moisturization,
emollient use, scavenging the necrotic tissue and debris from the surface of the skin ulcers as
well as immunomodulation of the host immune cells at the locale, and as such, these types of
medication have been employed for eczematous dermatitis, psoriasis, lichen planus, prurigo,
erythema multiforme, bullous diseases and even for lymphoma of the skin. On the other
hand, however, it has become increasingly accepted that these means of treatments have not
sufficed to bring relief from the refractory skin diseases. Such serious disorders include the
inexorably progressive skin cancers and the intractable inflammatory dermatoses.
Since last century, surgical resection has stood the test of time as golden standard of the
curative therapy for malignant solid tumors of the skin; malignant melanoma [1,2], squamous
cell carcinoma [3-5] and basal cell carcinoma [6,7] followed by the radiation treatment and
/ or the conventional chemotherapy according to conditions. In addition, the roles of the
checkpoint inhibitors [8,9] and molecular target-based drugs [10-13] in the treatment of
advanced stage melanoma are rapidly being established.
Another recent remarkable progress in dermatology concerns the development of
the biologics for the treatment of psoriasis, palmoplantar pustulosis, atopic dermatitis in
addition to urticaria. Novel insights into the immunopathogenesis of those diseases have
led to the development of new effective therapies. Taking psoriasis as an example, the active
components of the injected preparations are the antibodies against the cytokines responsible
for the pathogenesis; anti-Interleukin (IL) 23 , -Il-23/-IL-12 , -IL-17 [16,17], -IL-17
receptor A , and -TNF [19-21], based on the understanding of the major role of IL-17-
producing helper T lymphocyte. The clinical effects of these biologics were investigated with
overwhelmingly excellent results compared to the conventional topical therapies including
ointments and phototherapies, and well-tolerated throughout the duration of treatments.
These new therapies have been produced by the recent major advances of immunology,
and such multidisciplinary studies-based medications are now replacing the conventional
ointments therapy, promising the paradigm shift on dermatological treatments.
Professor, Chief Doctor, Director of Department of Pediatric Surgery, Associate Director of Department of Surgery, Doctoral Supervisor Tongji hospital, Tongji medical college, Huazhong University of Science and Technology