Pharmacologic Agents for Acne, Pigmentation Disorders, Rosacea, Psoriasis, and Alopecia (Part 1)

The following flashcards cover key terms and concepts related to pharmacologic agents used for dermatological conditions, focusing on definitions and mechanisms of action.

Topical corticosteroids

Anti-inflammatory medications used to treat skin conditions by reducing inflammation and suppressing the immune response.

Anti-infectives

Medications used to treat infections, including antibacterials and antifungals, relevant to dermatologic conditions.

Keratolytic

Agents that promote the shedding of the outer layer of skin, commonly used in treating acne and other skin disorders.

Adverse effects

Negative reactions or side effects associated with the use of a drug, which can include local or systemic toxicity.

Comedone

A clogged hair follicle (pore) in the skin, commonly known as a blackhead or whitehead.

Antiandrogens

Medications that block the effects of androgens (male hormones) in the body and are used in conditions like acne and hirsutism.

Immunomodulators

Agents that modify the immune system's response to conditions such as psoriasis or atopic dermatitis.

T-cell

A type of white blood cell that plays a central role in immune response and is involved in many skin inflammatory conditions.

Corticosteroid

A class of steroid hormones that are used to reduce inflammation, immune response, and are often used in dermatology.

JAK inhibitors

Drugs that inhibit Janus kinase pathways to reduce inflammation, used in conditions like atopic dermatitis.

Sensitivity reactions

Adverse responses that can occur in certain individuals after exposure to a drug, including skin reactions and anaphylaxis.

Biologics

Biological products derived from living organisms used to treat various chronic inflammatory conditions, primarily in dermatology.

Androgens

Hormones that regulate the development of male characteristics but can also influence skin conditions in both sexes.

Therapeutic effects

The desired, beneficial effects of a drug in treating a disease or condition.

Skin atrophy

Thinning of the skin often resulting from prolonged use of topical corticosteroids or other agents.

Photoaging

The premature aging of the skin caused by repeated exposure to ultraviolet radiation from sunlight.

Phototherapy

Treatment that involves exposure to specific wavelengths of light to treat skin conditions.

Immunosuppression

Reduction of the immune response, which can be a desired effect of certain medications for skin disorders.

Sebum

An oily secretion from sebaceous glands that can contribute to acne formation.

Alopecia

Hair loss that can occur due to a variety of factors including hormonal changes, autoimmune disorders, and genetics.

Post-inflammatory hypopigmentation

Loss of skin color that occurs after inflammation or injury to the skin.

Topical Corticosteroids

Drug Class: Corticosteroids

• Examples: Hydrocortisone, Betamethasone, Clobetasol

• Mechanism of Action: Reduce inflammation and suppress immune response by inhibiting phospholipase A2, thereby decreasing prostaglandin and leukotriene synthesis.

• Special Side Effects: Skin atrophy, striae, telangiectasias, acne, perioral dermatitis, hypopigmentation (with prolonged use).

Dermatologic Anti-infectives

Drug Class: Anti-bacterials & Anti-fungals

• Examples:

  • Antibacterials: Mupirocin (topical), Doxycycline (oral)

  • Antifungals: Ketoconazole (topical/oral), Terbinafine (oral)

• Mechanism of Action:

  • Antibacterials: Disrupt bacterial cell wall synthesis or protein synthesis.

  • Antifungals: Inhibit ergosterol synthesis, disrupting fungal cell membranes.

• Special Side Effects:

  • Topical: Local irritation, contact dermatitis.

  • Oral: Gastrointestinal upset, photosensitivity (doxycycline), hepatotoxicity (oral antifungals).

Keratolytics

Drug Class: Keratolytics (exfoliants)

• Examples: Salicylic Acid, Urea, Alpha Hydroxy Acids (AHAs)

• Mechanism of Action: Facilitate desquamation (shedding) of the stratum corneum by loosening intercellular connections or hydrating the skin.

• Special Side Effects: Skin irritation, dryness, peeling, photosensitivity.

Adverse effects

Negative reactions or side effects associated with the use of a drug, which can include local or systemic toxicity.

Comedone

A clogged hair follicle (pore) in the skin, commonly known as a blackhead or whitehead.

Antiandrogens

Drug Class: Hormone Modulators

• Examples: Spironolactone, Finasteride (primarily for hair loss/BPH, also has antiandrogenic effects)

• Mechanism of Action: Block androgen receptors, reduce androgen production, or inhibit 5-alpha-reductase (enzyme converting testosterone to DHT).

• Special Side Effects:

  • Oral Spironolactone: Hyperkalemia, menstrual irregularities, breast tenderness.

  • Oral Finasteride: Sexual dysfunction, mood changes (in men).

Topical Immunomodulators

Drug Class: Calcineurin Inhibitors, PDE4 Inhibitors

• Examples:

  • Topical Calcineurin Inhibitors: Tacrolimus, Pimecrolimus

  • Topical PDE4 Inhibitor: Crisaborole

• Mechanism of Action: Modify the immune system's response at the skin level.

  • Calcineurin Inhibitors: Block T-cell activation and cytokine release.

  • PDE4 Inhibitors: Inhibit phosphodiesterase-4, increasing intracellular cAMP, reducing inflammation.

• Special Side Effects: Local burning/stinging, pruritus, increased risk of skin infection (topical calcineurin inhibitors - note potential malignancy concerns, although data is mixed), skin irritation.

T-cell

A type of white blood cell that plays a central role in immune response and is involved in many skin inflammatory conditions.

Corticosteroid

A class of steroid hormones that are used to reduce inflammation and immune response, often used in dermatology.

JAK Inhibitors (Janus Kinase Inhibitors)

Drug Class: Small Molecule Immunosuppressants

• Examples: Tofacitinib, Upadacitinib, Baricitinib (for systemic use), Ruxolitinib (topical)

• Mechanism of Action: Block the Janus kinase (JAK) signaling pathway, which is crucial for immune cell function and inflammatory cytokine signaling.

• Special Side Effects: Serious infections, malignancy (including NMSC and lymphoma), major adverse cardiovascular events (MACE), thrombosis (PE, DVT), anemia, elevated lipids. (Often carry black box warnings for systemic use). Local reactions for topical.

Sensitivity reactions

Adverse responses that can occur in certain individuals after exposure to a drug, including skin reactions and anaphylaxis.

Biologics (Dermatology)

Drug Class: Monoclonal Antibodies, Fusion Proteins

• Examples: Adalimumab (TNF-$\alpha$ inhibitor), Ustekinumab (IL-12/23 inhibitor), Secukinumab (IL-17A inhibitor), Dupilumab (IL-4R $\alpha$ inhibitor)

• Mechanism of Action: Target specific cytokines (e.g., TNF-$\alpha$, IL-17, IL-23, IL-4, IL-13) or their receptors, disrupting inflammatory pathways in autoimmune diseases.

• Special Side Effects: Increased risk of serious infections (tuberculosis, fungal, bacterial), opportunistic infections, immunogenicity (antibody formation), injection site reactions, headache, fatigue. Specific risks vary by biologic (e.g., heart failure exacerbation with anti-TNF agents).

Androgens

Hormones that regulate the development of male characteristics but can also influence skin conditions in both sexes.

Therapeutic effects

The desired, beneficial effects of a drug in treating a disease or condition.

Skin atrophy

Thinning of the skin often resulting from prolonged use of topical corticosteroids or other agents.

Photoaging

The premature aging of the skin caused by repeated exposure to ultraviolet radiation from sunlight.

Phototherapy

Treatment that involves exposure to specific wavelengths of light to treat skin conditions.

Immunosuppression

Reduction of the immune response, which can be a desired effect of certain medications for skin disorders.

Sebum

An oily secretion from sebaceous glands that can contribute to acne formation.

Alopecia

Hair loss that can occur due to a variety of factors including hormonal changes, autoimmune disorders, and genetics.

Post-inflammatory hypopigmentation

Loss of skin color that occurs after inflammation or injury to the skin.