Immunologische Erkrankungen und Immuntherapie in der dermatologischen Praxis

Chronic inflammatory immune dermatoses (psoriasis with and without arthritis, atopic dermatitis, urticaria) represent an important and procentually large proportion of clinical cases in a dermatological practice. In order to optimize the care of patients with immune-dermatological diseases, we have been holding special immune consultations since 2019. During these special consultations we have been seeing patients with all of the above-mentioned diseases, but also with acne inversa, bullous dermatoses and skin problems resulting from side effects of therapies for autoimmune diseases of other organ systems (for example, myasthenia gravis, SLE, Sjögren's disease, multiple sclerosis) as well as immune deficiency diseases or hypo sensitization initiation. Immunomodulating therapies with biologics (monoclonal antibodies) as well as with small-molecule drugs, such as JAK inhibitors, show a favorable effectiveness-safety ratio and are widely used as a therapeutic means in our practice. In addition to immunological diagnostics and immunotherapies, the use of relevant vaccines is also part of the field of immunodermatology. In particular, our patient group had numerous immunological questions relating to SARS-CoV-2 and Covid-19 infections. Therapy management of inflammatory immune dermatoses with immunomodulating biologics is complex and comprises a clear indication, the consistent following of a therapy algorithm, the identification and diagnosis of potential side effects as well as photo and written documentation. Incorporating all of this into the daily routine of a dermatological practice represents a major challenge in organizational and particularly economical terms. The cooperation between dermatological practice and clinic is essential, especially in the field of immunotherapy and during the corona pandemic. Some of our patients were recruited from studies conducted at clinics. The immunomodulatory treatment of more than 200 patients under practice conditions over a two-year period allowed us to accumulate extensive experience. This is summarized in this study using 8 of our own publications (2 as first author, 6 as co-author). Clinical data were analyzed retrospectively. Therapeutic courses are presented and conclusions are drawn. This study is intended to contribute to the application of modern immunotherapies in dermatological practices.