Medical and surgical procedures
Biologic therapy in dermatology: psoriasis, atopic dermatitis and other diseases
Biologics are medications produced through biotechnology that selectively block molecules responsible for inflammation in skin diseases. They are used in moderate to severe cases of psoriasis, atopic dermatitis, chronic urticaria, hidradenitis suppurativa and other inflammatory diseases that have not responded well to conventional treatments, with injections at regular intervals. At Yamagata Dermatologia, in Ipanema, Rio de Janeiro, the indication and follow-up are done by dermatologists.
- How it is used
- Subcutaneous injections at regular intervals
- Indication
- Moderate to severe cases
- Before starting
- Tests and vaccination review
- Follow-up
- Regular appointments and tests
How it works
In inflammatory skin diseases, such as psoriasis and atopic dermatitis, some molecules of the immune system (cytokines) are in excess and keep the inflammation active. Biologics are laboratory-made antibodies that bind to one of these molecules, or to its receptor, and interrupt this signal.
Because they act on a specific target, the treatment controls the disease in a more targeted way than traditional immunosuppressants. There are different classes of biologics, with different targets, and the choice depends on the disease, each patient's characteristics and the presence of other conditions, such as psoriatic arthritis.
Indications
- PsoriasisModerate to severe psoriasis of the skin, nails and joints.
- Atopic dermatitisModerate to severe atopic dermatitis, with intense itching.
- UrticariaChronic urticaria that does not respond to antihistamines.
- Hidradenitis suppurativaModerate to severe hidradenitis.
Diseases treated
Diseases treatedPsoriasis · Psoriatic arthritis, together with the rheumatologist · Atopic dermatitis · Chronic spontaneous urticaria · Hidradenitis suppurativa
How treatment works
Before starting, the doctor orders blood tests, screening for tuberculosis and other infections, and a review of your vaccination record. The medications are given by subcutaneous injection, usually with pens or prefilled syringes, and many can be self-administered at home after instruction. The interval between injections varies with the medication.
Follow-up and care
The treatment requires regular appointments and tests to assess response and safety.
- Tell the doctor if you have a fever, infections or need surgery.
- Keep your vaccinations up to date, as advised (some live-virus vaccines should be avoided during treatment).
- Do not stop treatment without medical advice.
Results
Improvement is usually noticed in the first weeks, and the full response is assessed after a few months of use. The response varies from person to person and with the medication.
Contraindications
Biologics are not recommended for people with serious active infections, untreated tuberculosis or allergy to the medication. Pregnancy, a history of cancer, demyelinating diseases and heart failure require evaluation, depending on the class of medication.
At the evaluation, the dermatologist reviews your health history, current medications and previous procedures to confirm the indication.
All procedures are recommended and performed after an individual medical evaluation. Results vary from person to person.
Questions
Frequently asked questions
What are biologics?
They are medications produced through biotechnology, from living cells, that block a specific molecule involved in inflammation. Because they act in a targeted way, they control the disease without the broad action of traditional immunosuppressants.
Do biologics lower immunity?
They act in a targeted way on a specific part of the immune system. Before starting, tests are done, such as screening for tuberculosis, and vaccinations are reviewed, and treatment is followed with regular appointments.
Who can use biologics?
In general, people with moderate to severe forms of the disease who have not responded to, or cannot use, conventional treatments. The indication is made by the dermatologist, after a clinical evaluation and tests.
Do Brazilian health plans cover biologics?
Many biologics for skin diseases have mandatory coverage by Brazilian health plans or are available through SUS, Brazil's public health system, according to defined criteria. The clinic provides guidance on the required documentation after the indication.
Team