Angiogenesis for the clinician

Abstract

Angiogenesis, the development of a microvasculature to a neoplastic, inflammatory, or infectious disease process, is a promising therapeutic target that has not been fully exploited. Virtually all processes of therapy impinge on cutaneous angiogenesis. A proper understanding of cutaneous pathophysiology, with respect to angiogenesis, will lead to a more effective use of current therapies for dermatologic diseases, as well as development of novel therapies. With this knowledge, the clinician can make educated guesses on the effect of therapy on a process. The primary disorders of the skin are infectious, inflammatory, and neoplastic. All of these categories are capable of inducing angiogenesis through a limited and overlapping subset of mechanisms, and these mechanisms can be understood by the practicing dermatologist. This chapter discusses the primary mediators of angiogenesis and examples of common skin disorders in which they occur. Antiangiogenic therapy is also discussed. Factors that directly impact endothelium are called direct angiogenesis stimulators or inhibitors, while factors that stimulate nonendothelial cells to make stimulators or inhibitors are called indirect angiogenesis stimulators and inhibitors.