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Flashcards in Skin Pharmacology Deck (10):
1

What is the mainstay of treatment for eczematous dermatitis? What are some other options?

- topical corticosteroids are mainstay
- MOA: bind to lipocortin-1, inhibiting phospholipase A2 from activating arachidonic acid (so no LTs and PGs); they also inhibit IL-2 by inhibiting NF-kB
- (use antihistamines for mild cases such as urticaria and also to relieve pruritus)
- other option: topical calcineurin inhibitors
- MOA: inhibit calcineurin to prevent NFAT transcription of IL-2 gene

2

What is an extremely potent topical corticosteroid? What about a much weaker one?

- potent: betamethasone
- weak: hydrocortisone
- (corticosteroids bind to lipocortin-1, inhibiting phospholipase A2 from activating arachidonic acid, resulting in lowered LTs and PGs; they also inhibit IL-2 by inhibiting NF-kB)

3

What are the two major topical calcineurin inhibitors?

- tacrolimus and pimecrolimus
- (calcineurin inhibitors inhibit calcineurin to prevent NFAT transcription of IL-2 gene)

4

What are the mainstay treatments for psoriasis? What are some other options?

- topical corticosteroids and calcineurin inhibitors are mainstay
- corticosteroids: bind to lipocortin-1, inhibiting phospholipase A2 from activating arachidonic acid (so no LTs and PGs); they also inhibit IL-2 by inhibiting NF-kB
- calcineurin inhibitors: inhibit calcineurin to prevent NFAT transcription of IL-2 gene
- can also use methotrexate since the keratinocytes are rapidly dividing (blocks dihydrofolate reductase, preventing tetrahydrofolate production)
- other options: monoclonal Abs, vitamin D analogues (via D decreases keratinocyte proliferation), coal tars, salicylic acid (lyses keratinocytes)

5

How do we treat tinea?

- tinea is a fungal skin infection via dermatophytes
- it is treated with antifungals
- azoles and allylamines
- NOT treated with topical corticosteroids

6

How do we treat cutaneous candidiasis?

- candidiasis is via a fungus
- treat with antifungals (azoles, allylamines, nystatin) or topical corticosteroids

7

How do we treat acne vulgaris?

- this is a bacterial infection via Propionibacterium acnes
- treat with clindamycin in gel form (MOA: inhibits bacterial 50S ribosomal subunit)

8

How do we treat impetigo?

- this is a bacterial infection
- treat with mupirocin (inhibits bacterial protein synthesis)

9

How do we treat herpes simplex and herpes zoster?

- these are viral infections
- treat with aciclovir (a guanosine analog that inhibits viral DNA polymerase)
- can add benzoyl peroxide to current regimen for an extra kick

10

What pharmacological treatment is available for some skin cancers?

- Imiquimod is a topical treatment for basal cell carcinoma only (MOA: activates TLR-7 receptors, triggering the release of cytokines INF-alpha, IL-6, TNF-alpha, and activating macrophages; essentially, it stimulates the immune system to attack the carcinoma)
- fluorouracil can be given for actinic keratoses