David Fiorentino, MD, PhD

I am interested in the pathophysiology and treatment of patients with immune-mediated skin disease. I have laboratory experience in immunology and immunoregulation. In conjunction with Dr. Eliza Chakravarty, Assistant Professor of Rheumatology, we have developed a multi-disciplinary autoimmune skin disease clinic. This weekly clinic is dedicated to the management of patients with rheumatic skin disease, such as lupus erythematosus, scleroderma, dermatomyositis, vasculitis, and psoriasis/psoriatic arthritis.

Part of my research focus is to conduct clinical trials in patients with all types of immunologic skin disease. The skin is the only target organ in which you can actually visualize the direct effects of inflammation, without the need for surrogate markers. We are particularly interested in studying in vivo effects of targeted therapeutic agents in order to better understand the biology of different types of cutaneous inflammation. To this end, we conduct phase I, II, and III trials in patients with a diverse array of inflammatory skin diseases.

We are also creating a longitudinal clinical and tissue bank derived from patients seen in our clinics. One focus of this translational research effort is to understand the pathophysiology of dermatomyositis. This is a particularly challenging clinical model, as it is known to be associated with internal malignancy in up to 30% of patients. In addition, there is considerable heterogeneity between patients, in terms of skin versus muscle inflammation. We are using microarray technology to identify novel targets for disease as well as molecular signatures that will help clinicians to better manage their patients with this devastating disease. We believe that, from these studies, it will be possible to make accurate clinical predictions regarding: risk of internal malignancy, risk of lung disease, or response to various therapeutic agents.