On- and Off-Label Uses of Apremilast in Dermatology.

Apremilast is an oral small-molecule phosphodiesterase 4 inhibitor with a multilevel immunomodulating mechanism of action. It has received approval in many countries for the use in moderate-to-severe plaque psoriasis and active psoriatic arthritis in adults. Herein, we review the literature concerning the use of apremilast in dermatology, with a focus on both the on- and the off-label uses of this medication in dermatologic conditions. This paper is a systematic overview of all the reported uses of apremilast in dermatology described in the literature so far and was conducted according to the PRISMA Guidelines for systematic reviews. There are several original articles, case series and case reports In the literature that present either encouraging or less promising results concerning the efficacy and safety of apremilast in numerous inflammatory dermatological diseases. Despite the potential effectiveness of apremilast in various indications, however, randomized clinical trials on larger patient cohorts and with long-term follow-up are necessary in order to adequately establish the role of apremilast in dermatology overall.