The advent of complex therapies including biologics and small molecules has provided a new paradigm for the treatment of many immune mediated inflammatory conditions notably in rheumatology, gastroenterology (Inflammatory Bowel Disease) and also in dermatology. New dimensions of treatment can now be applied from this amazing therapeutic armamentarium at our disposal. In this podcast we will turn our attention to how this relates to management strategies in dermatology. The term ‘biologic’ refers to agents synthesised from the products of living organisms and includes monoclonal antibodies raised against cytokines including Tumour Necrosis Factor (TNF) or some of the interleukins. Contrasting these small molecules are laboratory produced and directed to inhibit the so-called JAK- STAT messaging system which was discovered to link the external world of cells with the transcription of proteins from the genetic code held within DNA. These complex molecules as a group inhibit cytokines, and thus modulate immune mediated inflammation. As they are specific in terms of their immune system action their safety profile is generally considered to be more favourable than that of traditional systemic immuno-suppressive drugs. In this conversation we talk with Associate Professor Peter Foley to expand our understanding of the place of these complex molecules in dermatologic management. In particular we will focus on psoriasis which affects 2-4 % of the world’s population with a higher prevalence in northern countries. Plaque psoriasis is the most common type encountered with its prominent feature being sharply demarcated erythrosquamous plaques. Hyperproliferation and abnormal differentiation of keratinocytes is the hallmark of psoriasis which may also manifest with arthritis in up to 30% of patients and be preceded by nail changes characterised by small but definite pits in 50-80 % of cases. Associate Professor Peter Foley graduated from Monash University in 1987 after completing a BMedSc thesis which was the first National Skin Cancer Survey. He later obtained a fellowship in dermatology in 1997 and completed an MD exploring the effects of Vitamin D on the skin. He is actively involved in research and has been principal investigator for numerous clinical trials which include more than 70 on subjects such as psoriasis, eczema, seborrheic dermatitis, rosacea and many more. He has an appointment as an Associate professor in the Department of Medicine -Dermatology at The University of Medicine and is director of research and immediate Past-President of the Skin and Cancer Foundation. He is Australia’s only councillor on the International Psoriasis Council and sits on the Board of the Photomedicine Society. Clearly, he is well credentialed to discuss current approaches to using Biologics and Small molecules in dermatologic practice and we welcome him to the podcast. References: Assoc Professor peter Foley: Foley Dermatology and associates. www.foleydermatology.com.au Biologics in Dermatology: An Integrated Review, Seghal et al. ncbi.nlm. nih.gov The Australian College of Dermatologists, Biologic Treatments Used in Dermatology www.dermoll.edu.au