Non-psoriatic dermatologic uses of monoclonal antibody therapy

Monoclonal antibodies have been employed in the treatment of dermatologic disease for quite some time, primarily for psoriasis. Nevertheless, there are numerous case reports detailing successful and unsuccessful treatment of non-psoriatic dermatologic disease with these agents. In most cases, their use is off-label, as the FDA has approved monoclonal antibody use for only a few dermatologic diseases. The most commonly used monoclonal antibodies in dermatology are omalizumab, infliximab, rituximab, adalimumab, and efalizumab, and the disorders of interest include but are not limited to hidradenitis suppurativa, atopic dermatitis, pyoderma gangrenosum, and various blistering diseases. A review of these cases will hopefully encourage the use of monoclonal antibodies in dermatology via development of large, adequately powered clinical trials. This will hopefully result in FDA approval of monoclonal antibodies for a larger variety of recalcitrant, difficult-to-treat dermatologic illnesses.