DEPT.

OF PHARMACOLOGY
DERMATOLOGICAL PHARMACOLOGY

The essensial function of skin :

protection
thermoregulation
immune responsiveness
biochemical synthesis
sensory detection
social and sexual communication
Therapy to correct dysfunction in any of
these activities may be delivered:
systemically.
intralesionally
topically depend on understanding
the barrier function of the skin, primarily

within the stratum corneum.

ultraviolet radiation
Corticosteroids and retinoids are important
systemic and topical therapeutic agents for
skin disease.
Antibacterial, antiviral and antifungal agents
are employed widely both oral
antimalarial, chemotherapeutic and
immunosupressive agents, dapsone, and
antihistamine, frequently are used for treatment
of dermatological diseases.
Calcipotrien, a vitamine D analog, and
anthraline are mayor topical agents for
psoriasis.
Ultraviolet radiation therapy is frequent mode
Of treatment for psoriasis, independently or
combination with drugs such as psoralens or
coaltar
The prophylactic use of sunscreens may
reduce or prevent premalignant or malignant
skin lesions induce by UV light.
General Guidelines for Topical Therapy
1. Regional Anatomic Variation
- Drug penetration higher on the face, intertriginous
area, and especially in the perineum.
- Sensitization, irritation, and atropy from
steroidare more likely to develop in these regions.
2. Altered Barrier Function
- psoriasis Str. corneum is abnormal
barrier function is lost topical absorption is
increased systemic toxicity.
3. Hydration
- drug absorption is increased
- produce by inhibiting transepidermal loss of
water,
(occlusion with an impermeable film,
application of lipophilic cclusive vechicle such
as oinment)
4. Vechicle
- acute inflamation aqueous drying preparation
- chronic inflamation hydrating preparations.
- soaks acute moist eruptions
- Lotions (powder in water suspension) and
solutions (medications dissolve in a solvent)
for hairy and intertriginous areas.
- Creams or oil inwater emulsions are absorbable
and are the most cosmetically acceptable.
- Ointments, water in oil emulsions are the most
effective hydrating agents scally eruption.
- Multiple creams and oinments without active
drug are marketed as moisturizing agents.
5. Age
6. apllication frequency
Topical Glucocorticoids
Therapeutic Uses:
inflamatory skin diseases
twice a day application is sufficient
hydrocortison is the most potent steroid used
on the face or in occluded areas (axilla or groin)
tachyphylaxis can occur.
intralesional injection : triamcinolone scalp
allopecia, panniculitis, psoriasis, discoid lupus
and inflamed cysts.
Toxicity and Monitoring
- skin atrophy, striae, teleangiectasias purpura,
acneiform eruptions, perioral dermatitis,
overgrowth of skm fungus and bacteria,
hypopigmentation in pigmented skin, and rosacea.
- factors that increase systemic absorption : the
amount of the steroid applied, the extent of the
area treated, the frequency of application, the
length of treatment, the potency of the drug and
the use of occlusion.
- intralesional glucocorticoids can cause cutaneous
atrophy and hypopigmentation
Systemic Glucocorticoids
Therapeutic uses:
A. Require long-term therapy:
- Bullous diseases:- pemphigus vulgaris
- herpes gestationis.
- Collagn Vascular Diseases : - S.L.E.
- vasculitis
- Sarcoidosis
- Sweets disease
- Pyoderma gangrenosum
- Type l reactive leprosy
B. Respond to short-term therapy :
- Contact dermatitis (acute)
- Atopic dermatitis
- Lichen planus
- Exfoliative dermatitis
- Erythema nodosum
C. Respond to low-dose bedtime therapy :
- Acne
- Hirsuitisme
D. Steroid therapy controversial
- Toxic epidermal necrolysis
- Erythema multiforme
- Cutaneous T - Cell lymphoma
- Discoid L.E.
Toxicity and Monitoring
Short-term use:
> psychiatric problems, cataracts,myopathy,
avascular necrosis, hypertension.

Withdrawl syndrome :
- transient arthralgias, myalgias, joint effusions
- Isotretinoin ( I )
- Etetrinate ( E)
- Tretinoin (T)
Mayor Retinoid-Responsive Skin Diseasea
Acne 1,(T)
Disorders of keratinization I,E,(T)
Skin cancer I,E
Precancereous T,E,(I)
Psoriass E
Cutaneous aging T
TOPICAL ANTIPSORIASIS DRUGS
- Calcipotriene
- Anthralin

PHOTOCHEMOTHERAPY
1. PSORALEN
2. BERGAPTEN
3. METHOXALEN
4. TRIOXALEN
Therapeutic Uses:
vitiligo
psoriasis
PUVA also is employed in the treatment of:
- cutaneous T-Cell lymphoma
atopic dermatitis
- alopecia areata
- lichen planus
 Sunscreens are topical agents that reduce the
amount of ultraviolet radiation reaching the Skin or
block it altogether.
I. physical 3 Sunscreen :
This sunscreen contain large particulate
ingredients that reflect and scatter UVA, UVB, and
visible light. These ingredients include :
- Titanium dioxide
- Talc
- magnesium oxide
- zinc oxide
- kaolin
- ferric chloride
- Ichthamnol
II. Chemical sunscreens.
Protection against UVB is more effective, than
Protection against UVA.
- p-ammobenzoic acid esters
- cinnamates effective UVB
- salicylates blocking

- benzophenones
- anthranilates effective UVA blocking
- avobenzone
- Minoxidil Stimulating hair growth.
- Keratolytic agent : - lactid acid
- glycolic acid
- salcylic acid.
-Destructive agents: - Podophyllin
- Trichloroacetic acid
- Hydroquinone HYPERPIGMENTATION
- Capsaicin relief of post herpetic neuralgia
(R/ : ZOSTRIC, ZOSTRIC HP)
- Masoprocol Th/ ACTINIC KERATOSIS
- Colchicine PMN leukocytes are part of the
pathogenesis of the disease
- Gold Pemphigus vulgaris and cutaneous LE