Phosphodiesterase (PDE) Inhibitors for the Treatment of Inflammatory Skin Conditions

The document from January 1, 2018, reviewed the use of phosphodiesterase (PDE) inhibitors, particularly PDE4 inhibitors such as apremilast, in treating inflammatory skin conditions. Apremilast was FDA-approved in 2014 for moderate to severe plaque psoriasis and psoriatic arthritis, showing over 46.7-57% of patients with a >50% improvement in PASI scores after 12 weeks. It also demonstrated long-term efficacy in psoriatic arthritis with 60.9% of patients achieving ACR20 at week 104. Apremilast showed potential for other skin conditions, including palmoplantar psoriasis, nail and scalp psoriasis, atopic dermatitis, alopecia areata, and more. However, adverse events and high costs may affect its use. Topical PDE4 inhibitors like crisaborole were FDA-approved in December 2016 for mild to moderate atopic dermatitis, with significant improvements in clinical trials but with some adverse effects and concerns about long-term safety and cost. Further trials are needed to fully assess the efficacy and safety of PDE inhibitors for various skin conditions.