Crisaborole in Dermatology

Phosphodiesterase 4 (PDE4) is crucial in inflammatory skin conditions, increased activity leads to elevated proinflammatory cytokine, contributing to disease pathology like atopic dermatitis (AD). Crisaborole, a topical PDE4 inhibitor, with favorable pharmacokinetics, good skin penetration, minimal systemic absorption, effectively reduces proinflammatory mediators and reactive oxygen species. The ointment is applied topically twice daily and is well-tolerated with minor side effects like application site pain, which typically resolves quickly. In clinical trials, crisaborole has shown significant efficacy in treating AD, chronic plaque psoriasis and vitiligo. At present, the mainstay for management of chronic inflammatory skin diseases is topical corticosteroids and calcineurin inhibitors, but their long-term use is associated with adverse effects such as skin atrophy, telangiectasia, hypertrichosis, hypothalamo-pituitary axis suppression and increased risk of skin cancers, respectively. Crisaborole offers a safer alternative with fewer side effects. Despite promising results, further studies are necessary to expand its indications, particularly for other inflammatory skin diseases such as psoriasis and vitiligo, where the research is limited.