Dermatologic Agents

• Dermatological agents:
–Indication
-Acne , burns ,Ichthyosis ,Pachyonychia Congenita ,
Pemphigus , Psoriasis ,Raynaud's Phenomenon
Rosacea ,Scleroderma , Vitiligo ,Eczema, Atopic
dermatitis, Cold Sores, Cold sores , Dry
Skin ,Contact Dermatitis ,Melasma, etc.
– Types of dermatologic medication
A. Topical categories:
- lotions , creams , gels ,pastes , ointments , transdermal patches , powders.
-Antibiotic
-Antifungal ,etc.

B. Oral categories:
-Antimicrobials (antibacterials, antifungals),
-Antiparasitics, NSAIDs,
- Immunomodulators,
-Hormones,
-Psychotropic agents,
-Vitamin and mineral supplements.

* Common antibiotics includes: dicloxacillin, erythromycin, and tetracycline

*Oral antifungal drugs includes: fluconazole and itraconazole
Commonly Prescribed Drug Types in
Dermatology:
• TOPICAL STEROIDS
• SYSTEMIC STEROIDS
• TOPICAL CALCINEURIN INHIBITORS
• PDE-4 INHIBITORS
• ANTIHISTAMINES
• Other Medications used to treat skin conditions
TOPICAL STEROIDS
• Topical steroids are treatment for any kind of dermatitis or steroid-
responsive dermatoses
• Topical steroids used to treat psoriasis, vitiligo, lichen sclerosus,
atopic dermatitis, eczema, and acute radiation dermatitis
• Ultra-high-potency topical steroids should not be used
continuously for longer than three weeks.
• Side effects of topical corticosteroids :inflamed hair follicles
(folliculitis) ,thinning of the skin.
• long-term use has in some cases led to permanent striae on the
skin, bruising, discolouration, or thin spidery blood vessels
 SYSTEMIC STEROIDS

• Systemic (cortico)steroids are also called glucocorticoids or

cortisones.
• can be used for skin conditions such as: Severe hand
dermatitis. Lichen planus. Bullous pemphigoid.
• Short-term use of the drugs, however, can cause a bump up
in glucose among patients with diabetes and there is an
increased risk of sepsis in the 90 days after getting short term
systemic steroids.
• Systemic steroids can be used for skin conditions such as:
Severe hand dermatitis. Lichen planus. Bullous pemphigoid.
 TOPICAL CALCINEURIN INHIBITORS
• Topical calcineurin inhibitors (TCIs) work by altering the immune
system and have been developed for treating atopic eczema
• There are two types available: tacrolimus ointment (Protopic) for
moderate to severe eczema and pimecrolimus cream (Elidel) for mild
to moderate eczema.
• The most commonly reported side effect of topical calcineurin
inhibitors is local skin irritation (burning, pruritus, and erythema) at the
application site. However, this is usually transient and decreases over
time (usually within one month).
• Other adverse effects may include: Allergic contact dermatitis.
PDE-4 INHIBITORS

• Phosphodiesterase-4 (PDE4) is the major enzyme class

responsible for the hydrolysis of cyclic adenosine
monophosphate (cAMP), an intracellular second messenger
that controls a network of proinflammatory and
antiinflammatory mediators.
• as a treatment for several autoimmune conditions including
ankylosing spondylitis, Alzheimer's disease, psoriasis, psoriatic
arthritis, sarcoidosis, systemic lupus erythematosus,
inflammatory bowel disease, atopic dermatitis, rheumatoid
arthritis
ANTIHISTAMINES

• therapy is widely used in the treatment of allergic

dermatoses
• treatment of acute and chronic urticaria, angioedema,
atopic dermatitis, different forms of eczema and various
drug-induced reactions.
• Claritin (loratadine) is an antihistamine used to treat
allergy symptoms.
Other Medications used to treat skin conditions
• Antibacterials: These medicines, including mupirocin or clindamycin, are often used to treat or prevent infection.
• Anthralin : This drug, though not often used because it can be irritating and can stain, helps reduce inflammation and can
help treat psoriasis.
• Antifungal agents: Clotrimazole (Lotrimin), ketoconazole (Nizoral), and terbinafine (Lamisil AT), are a few examples of
common topical antifungal drugs used to treat skin conditions such as ringworm and athlete's foot.
• Benzoyl peroxide: Creams, gels, washes, and foams containing benzoyl peroxide are used to treat acne.
• Coal tar : This topical treatment is available with and without a prescription, with strengths ranging from 0.5% to 5%. Coal tar
is used to treat conditions including seborrheic dermatitis (usually in shampoos) or psoriasis. Currently, coal tar is seldom
used because it can be slow acting and can cause severe staining of personal clothing and bedding.
• Corticosteroids: These are used to treat skin conditions including eczema. Corticosteroids come in many different forms
including foams, lotions, ointments, and creams.
• Non-steroidal ointment: The ointments crisaborole (Eucrisa) and tacrolimus (Protopic) and the cream pimecrolimus (Elidel)
also are prescribed for eczema, including atopic dermatitis.
• Retinoids: These medications (such as Differin, Retin-A, and Tazorac) are gels, foams, lotions, or creams derived from
vitamin A and are used to treat conditions including acne.
• Salicylic acid :This drug is sold in lotions, gels, soaps, shampoos, washes, and patches. Salicylic acid is the active ingredient
in many skin care products for the treatment of acne and warts.
– Dermatologically tested
-relates to the fact that the finished product has been tested on human skin; that
the formula is mostly safe to be applied on the skin; that the finished product is
well tolerated and in most cases will not cause a skin reaction.
-HRIPT test (human repeat insult patch test) ,is used to help predict the
likelihood for induced allergic contact dermatitis (ACD) of topically applied
products.
– Adverse effect
Adverse effects of Dermatologic Preparations:
-Stinging or burning
-Drying and irritation
-Pruritus
-Erythema
-sensitization
-staining
-superfacial erosion
– Side-effects
Skin-related side effects include:
-Acne-like rash on face and upper body.
-Inflammation around fingernails.
-Dry, itchy skin.
-Fingertip cracking.
-Hair loss on scalp.
-Increased, curly, or coarse hair on face and eyelashes.
-Increased sensitivity to sunlight.
– Allergic reactions
-exanthematous
- urticarial
- blistering, and
-pustular eruptions
– Nursing consideration
-Always wear gloves and maintain standard precautions
-Always clean the skin or wound before applying
-Thorough history, including work history, must be carefully
reviewed
-assess for known allergy
-skin assessment
-educate your patients about using them correctly
- monitor as to the adverse effects and other sign of infection
References:

• Karch, A. M., & Karch. (2011). Focus on nursing

pharmacology. Wolters Kluwer Health/Lippincott Williams
& Wilkins.

• Katzung, B. G. (2017). Basic and clinical pharmacology.

McGraw-Hill Education.

• Gersch,C.(2017).Pharmacology Made Incredibly

Easy.Wolters Kluwer Health/Lippincott Williams & Wilkins.