Week 3 - Dermatological Therapeutics Flashcards
What are the actions, uses and adverse effects of corticosteroids?
Actions: anti-inflammatory, immunosuppressive, anti-proliferative, vasoconstrictive
Uses: eczema, contact dermatitis, psoriasis, itch, lichen planus
Adverse effects: Skin atrophy/thinning, acne, striae
How do retinoids work?
Vitamin A analogs - work through nuclear receptors on DNA causing alteration of gene transcription
What are retinoids used for?
Acne, psoriasis, cosmetic skin improvement
What are adverse effects of retinoids?
dryness, irritation, sun sensitivity
What are the actions of retinoids?
Regulate cell growth, inhibit carcinogenesis, alter enzymes involved with cellular differentiation
How does Calcipotriene work? What is it used for and what are some adverse effects of it?
Ex: Donovex
A vitamin D analog that acts through DNA receptors to alter skin differentiation
Uses: psoriasis, eczema
Adverse effects: irritation, increased serum calcium
What are some topical antimicrobials and what are they used for?
Clindamycin, erthyromycin gels, benzoyl peroxide gel or wash, terbinafine, oxiconazole creams,
Uses: acne, rosacea, wounds, fungal infections
How do Topical Calcineurin Inhibitors (TCIs) work?
They work through calcineurin to alter T-cell activation
What are TCIs used for and why are they controversial?
- Work well for eczema (atopic dermatitis)
- May cause limited local irritation or burning
- Has FDA warning because it caused lymphomas in animal studies
What is atopic dermatitis?
Eczema!
What is dermatitis?
Inflammation of the skin
What does broad spectrum mean? And how much of the suns rays does SPF 30 block?
- covers all wavelengths
- blocks 97% of sun’s UV rays
How does an imiquimod work?
- Aldara cream
- ramps up the immune system to attack something in skin (immune response modifier)
- works through toll receptors to activate immune cascades locally
- Used for actinic keratosis, BCC
What is topical 5-Fluorouracil?
It inhibits thymidylate synthase, resulting in reduced DNA synthesis. It acts selectively in actinic damaged skin cells
How should you take care of wounds?
-Keep wound covered with a nonstick dressing to allow natural cytokines to facilitate healing (don’t want to ‘air out’ as this increases scarring)
What are systemic retinoids used for and how do they work?
They are used for acne, psoriasis, ichthyosis, chemopropholaxis of skin –> repair disordered keratinization (Accutane)
- They are vitamin A analogs that bind to nuclear retinoid receptors to alter cell differentiation
- They have many adverse effects and need to be monitored closely (government regulates accutane)
What can systemic retinoids do?
They can cure/remove acne permanently and they are used for psoriasis that has multiple spots
What is dapsone used for?
Leprosy therapy!
-Dermatitis herpiformis, linear IgA disease, bullous lupus, spider bites
What is methotrexate (systemic drug) used for?
Psoriasis & lupus
How does methotrexate work?
Dihydrofolate reductase inhibitor that disrupts DNA synthesis to block cell division. Immunosuppressive
What are systemic biological therapies?
Biogenetically engineered proteins which disrupt/inhibit focused portions of the immune system involved in psoriasis
-Used to treat psoriasis, psoriatic arthritis, (RA)
What are some cons to using biological therapies?
VERY Expensive
- Injection site irritation
- Risk of infection
- Our bodies can develop antibodies to these
How are biological therapies given?
They are given as a vaccination every other week.
What is ultraviolet light therapy used for?
Anti-inflammtory, immunosuppresive
- Used for psoriasis, pruritis, ezcema, CTCL (cutaneous T cell lymphoma)
