Principles of Systemic Therapy

Key Features

  • Systemic therapy for dermatologic disease is generally safe, but requires knowledge of the patient's medical history, potential drug side effects, toxicity monitoring guidelines, and potential drug interactions.

  • Identification of genetic polymorphisms in drug metabolism allows in some cases for predicting those patients at risk for adverse drug reactions.


Systemic Therapy Xanthine Oxidase Bullous Pemphigoid Topical Therapy Dermatologic Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Wolverton SE (2001) Principles for maximizing the safety of dermatologic drug therapy. In: Wolverton SE (ed) Comprehensive dermatologic drug therapy, 1st edn. W.B. Saunders, Philadelphia, pp 15–26Google Scholar
  2. 2.
    Aria N, Kauffman CL (2003) Important drug interactions and reactions in dermatology. Dermatol Clin 21(1):207–215, ixPubMedCrossRefGoogle Scholar
  3. 3.
    Ahmad N, Mukhtar H (2004) Cytochrome p450: a target for drug development for skin diseases. J Invest Dermatol 123(3):417–425PubMedCrossRefGoogle Scholar
  4. 4.
    Ameen M, Smith CH, Barker JN (2002) Pharmacogenetics in clinical dermatology. Br J Dermatol 146(1):2–6PubMedCrossRefGoogle Scholar
  5. 5.
    Barzilai DA, Freiman A, Dellavalle RP, Weinstock MA, Mostow EN (2005) Dermatoepidemiology. J Am Acad Dermatol 52(4):559–573; quiz 74–78PubMedCrossRefGoogle Scholar
  6. 6.
    Gupta MA, Johnson AM, Chren MM (2005) Evaluating clinical rating scales for evidence-based dermatology: some basic concepts. Dermatol Clin 23(4):703–706PubMedCrossRefGoogle Scholar
  7. 7.
    Cauwenbergh G (2002) The role of the pharmaceutical industry in drug development in dermatology. Clin Dermatol 20(5):467–473PubMedCrossRefGoogle Scholar
  8. 8.
    Collier A, Johnson KR, Delamere F, Leonard T, Dellavalle RP, Williams H (2005) The Cochrane Skin Group: promoting the best evidence. J Cutan Med Surg 9(6):324–331PubMedCrossRefGoogle Scholar
  9. 9.
    Kazlow Stern D, Tripp JM, Ho VC, Lebwohl M (2005) The use of systemic immune moderators in dermatology: an update. Dermatol Clin 23(2):259–300PubMedCrossRefGoogle Scholar
  10. 10.
    Young HS, Summers AM, Read IR et al (2006) Interaction between genetic control of vascular endothelial growth factor production and retinoid responsiveness in psoriasis. J Invest Dermatol 126(2):453–459PubMedCrossRefGoogle Scholar
  11. 11.
    de Leon J, Susce MT, Murray-Carmichael E (2006) The AmpliChip CYP450 genotyping test: integrating a new clinical tool. Mol Diagn Ther 10(3):135–151PubMedCrossRefGoogle Scholar
  12. 12.
    Lowitt MH, Shear NH (2001) Pharmacogenomics and derma-tological therapeutics. Arch Dermatol 137(11):1512–1514PubMedGoogle Scholar
  13. 13.
    Wolkenstein P, Carriere V, Charue D et al (1995) A slow acetylator genotype is a risk factor for sulphonamide-induced toxic epidermal necrolysis and Stevens-Johnson syndrome. Pharmacogenetics 5(4):255–258PubMedCrossRefGoogle Scholar
  14. 14.
    Patel AA, Swerlick RA, McCall CO (2006) Azathioprine in dermatology: the past, the present, and the future. J Am Acad Dermatol 55(3):369–389PubMedCrossRefGoogle Scholar
  15. 15.
    Holme SA, Duley JA, Sanderson J, Routledge PA, Anstey AV (2002) Erythrocyte thiopurine methyl transferase assessment prior to azathioprine use in the UK. QJM 95(7):439–444PubMedCrossRefGoogle Scholar
  16. 16.
    Oates JA (2006) The science of drug therapy. In: Brunton LL (ed) Goodman and Gilman's the pharmacological basis of therapeutics, 11th edn. McGraw-Hill, New YorkGoogle Scholar
  17. 17.
    Shapiro LE, Shear NH (2002) Drug interactions: proteins, pumps, and P-450s. J Am Acad Dermatol 47(4):467–484; quiz 85–88PubMedCrossRefGoogle Scholar
  18. 18.
    Shapiro LE, Shear NH (2001) Drug interactions. In: Wolverton SE (ed) Comprehensive dermatologic drug therapy, 1st edn. W.B. Saunders, Philadelphia, pp 848–871Google Scholar
  19. 19.
    Chin TW, Loeb M, Fong IW (1995) Effects of an acidic beverage (Coca-Cola) on absorption of ketoconazole. Antimicrob Agents Chemother 39(8):1671–1675PubMedCrossRefGoogle Scholar
  20. 20.
    Jaruratanasirikul S, Kleepkaew A (1997) Influence of an acidic beverage (Coca-Cola) on the absorption of itracon-azole. Eur J Clin Pharmacol 52(3):235–237PubMedCrossRefGoogle Scholar
  21. 21.
    Lebwohl M, Ellis C, Gottlieb A et al (1998) Cyclosporine consensus conference: with emphasis on the treatment of psoriasis. J Am Acad Dermatol 39(3):464–475PubMedCrossRefGoogle Scholar
  22. 22.
    Roenigk HH Jr, Auerbach R, Maibach H, Weinstein G, Lebwohl M (1998) Methotrexate in psoriasis: consensus conference. J Am Acad Dermatol 38(3):478–485PubMedCrossRefGoogle Scholar
  23. 23.
    Lebwohl M, Menter A, Koo J, Feldman SR (2004) Combination therapy to treat moderate to severe psoriasis. J Am Acad Dermatol 50(3):416–430PubMedCrossRefGoogle Scholar
  24. 24.
    Ang GC, Werth VP (2005) Combination antimalarials in the treatment of cutaneous dermatomyositis: a retrospective study. Arch Dermatol 141(7):855–859PubMedCrossRefGoogle Scholar
  25. 25.
    Dick SE, Werth VP (2006) Pemphigus: a treatment update. Autoimmunity 39(7):591–599PubMedCrossRefGoogle Scholar
  26. 26.
    Lockshin B, Wolverton S (2007) Polymorphims: why individual drug responses vary. In: Wolverton S (ed) Comprehensive der-matologic drug therapy. W. B. Saunders, Philadelphia, pp 27–36Google Scholar
  27. 27.
    Jones SK (1999) Ocular toxicity and hydroxychloroquine: guidelines for screening. Br J Dermatol 140(1):3–7PubMedCrossRefGoogle Scholar
  28. 28.
    Callen JP, Camisa C (2001) Antimalarial agents. In: Wolverton SE (ed) Comprehensive dermatologic drug therapy, 1st edn. W.B. Saunders, Philadelphia, pp 251–268Google Scholar
  29. 29.
    Maurice PD, Maddox AJ, Green CA, Tatnall F, Schofield JK, Stott DJ (2005) Monitoring patients on methotrexate: hepatic fibrosis not seen in patients with normal serum assays of aminoterminal peptide of type III procollagen. Br J Dermatol 152(3):451–458PubMedCrossRefGoogle Scholar
  30. 30.
    Wong GA, Shear NH (2005) Adverse drug interactions and reactions in dermatology: current issues of clinical relevance. Dermatol Clin 23(2):335–342PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Department of DermatologyUniversity of CaliforniaSan FranciscoUSA

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