Coal tar solution 12% / Salicylic acid 2% in Hydrocortisone 1% ointment

The dysregulated phosphatidylinositol-3-kinase (PI3K)-Akt-mammalian target of rapamycin (mTOR) signaling pathway has been implicated in various immune-mediated inflammatory and hyperproliferative dermatoses such as acne, atopic dermatitis, alopecia, psoriasis, wounds, and vitiligo, and is associated with poor treatment outcomes. Improved comprehension of the consequences of the dysregulated PI3K/Akt/mTOR pathway in patients with inflammatory dermatoses has resulted in the development of novel therapeutic approaches. Nonetheless, more studies are necessary to validate the regulatory role of this pathway and to create more effective preventive and treatment methods for a wide range of inflammatory skin diseases. Several studies have revealed that certain natural products and synthetic compounds can obstruct the expression/activity of PI3K/Akt/mTOR, underscoring their potential in managing common and persistent skin inflammatory disorders. This review summarizes recent advances in understanding the role of the activated PI3K/Akt/mTOR pathway and associated components in immune-mediated inflammatory dermatoses and discusses the potential of bioactive natural products, synthetic scaffolds, and biologic agents in their prevention and treatment. However, further research is necessary to validate the regulatory role of this pathway and develop more effective therapies for inflammatory skin disorders.

Abstract licence: CC BY

Inflammatory dermatoses, including psoriasis, atopic dermatitis (AD), and acne vulgaris, pose significant challenges in dermatological treatment due to the skin's natural barrier, the stratum corneum (SC), which limits the efficacy of topical formulations. Iontophoresis, a non-invasive technique that applies low-level electrical currents to enhance transdermal drug delivery, has emerged as a promising solution to overcome these barriers. This review explores the application of iontophoresis-assisted drug delivery for treating inflammatory skin conditions, focusing on its mechanisms, benefits, and potential for combination with existing topical formulations. Iontophoresis enhances the penetration of both small molecules, such as corticosteroids, and biological macromolecules, including monoclonal antibodies and nucleic acid-based therapies, into deeper skin layers. This optimized therapeutic delivery maximizes localized efficacy while minimizing systemic exposure and potential adverse effects. Furthermore, when combined with other transdermal enhancement techniques such as microneedles and sonophoresis, iontophoresis demonstrates synergistic effects, facilitating the delivery of challenging drug molecules and enabling controlled, targeted release. Recent advances in wearable iontophoresis devices present new opportunities for continuous and patient-friendly drug administration, particularly for chronic conditions requiring long-term management. Despite these advantages, challenges such as variability in skin response, potential irritation, and device costs remain. Further research and technological advancements are needed to optimize iontophoresis systems for broader clinical applications. Overall, this review highlights the versatility and prospects of iontophoresis as an innovative therapeutic approach in managing inflammatory dermatoses.

Abstract licence: CC BY

Psoriasis (PSO) is a chronic autoimmune skin condition characterized by the rapid and excessive growth of skin cells, which leads to the formation of thick, red, and scaly patches on the surface of the skin. These patches can be itchy and painful, and they may cause discomfort for patients affected by this condition. Therapies for psoriasis aim to alleviate symptoms, reduce inflammation, and slow down the excessive skin cell growth. Conventional topical treatment options are non-specific, have low efficacy and are associated with adverse effects, which is why researchers are investigating different delivery mechanisms. A novel approach to drug delivery using nanoparticles (NPs) shows promise in reducing toxicity and improving therapeutic efficacy. The unique properties of NPs, such as their small size and large surface area, make them attractive for targeted drug delivery, enhanced drug stability, and controlled release. In the context of PSO, NPs can be designed to deliver active ingredients with anti-inflammatory effect, immunosuppressants, or other therapeutic compounds directly to affected skin areas. These novel formulations offer improved access to the epidermis and facilitate better absorption, thus enhancing the therapeutic efficacy of conventional anti-psoriatic drugs. NPs increase the surface-to-volume ratio, resulting in enhanced penetration through the skin, including intracellular, intercellular, and trans-appendage routes. The present review aims to discuss the latest approaches for the topical therapy of PSO using NPs. It is intended to summarize the results of the in vitro and in vivo examinations carried out in the last few years regarding the effectiveness and safety of nanoparticles.

Abstract licence: CC BY