<\/span><\/h2>\nConsult the standard texts and locally approved data sheets for detailed pharmacology and therapeutic information on the immunomodulatory drugs discussed here.<\/p>\n
Second-line drugs commonly used in dermatology<\/span> (on or off label) include:<\/p>\n\n- \n
Methotrexate<\/p>\n
\n- The dose is 5 to 30 mg once a week (orally or subcutaneous<\/span>)<\/li>\n
- Folic acid 5 mg is also often prescribed.<\/li>\n<\/ul>\n<\/li>\n
- \n
Azathioprine<\/p>\n
\n- The dose is 1-3 mg\/kg\/day<\/li>\n
- Take 1 hour before or 3 hours after food.<\/li>\n<\/ul>\n<\/li>\n
- \n
Cyclosporine<\/p>\n
\n- Dosage is 2.5 to 5 mg\/kg\/day in 2 divided doses<\/li>\n
- Caution if you change brands<\/li>\n<\/ul>\n<\/li>\n
- TNF\u03b1 inhibitors (biologics)\n
\n- A loading dose is usual<\/li>\n
- A maintenance dose of etanercept is 50 mg sc every week<\/li>\n
- A maintenance dose of adalimumab is 40 mg sc every other week.<\/li>\n
- A maintenance dose of infliximab is 5 mg\/kg IV every eight weeks.<\/li>\n
- A maintenance dose of ustekinumab is 45 or 90 mg sc every 12 weeks.<\/li>\n
- A maintenance dose of secukinumab is 300 mg every four weeks.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
These are prescribed by specialists, but other health professionals may be involved in the patient's care. They must take into account at least the indications, contraindications<\/span>, adverse effects and monitoring requirements.<\/p>\n<\/span>Indications for immunomodulatory drugs<\/span><\/h2>\nImmunomodulatory drugs are used for various chronic<\/span> inflammatory<\/span> skin conditions that are not adequately controlled in other ways. The skin disease must be serious or have a serious or functional function. psychosocial<\/span> impact on the patient.<\/p>\n<\/span>Examples of suitable conditions.<\/span><\/h3>\n\n- Chronic license plate<\/span> psoriasis<\/li>\n
- Atopic<\/span> eczema<\/span><\/li>\n
- Hand dermatitis<\/span><\/li>\n
- Chronic photosensitivity<\/span> dermatitis<\/li>\n
- Lichen planus<\/li>\n
- Bullous<\/span> pemphigoid<\/li>\n
- Hidradenitis suppurativa<\/li>\n
- Spontaneous Chronicle urticaria<\/span><\/li>\n
- Drug-induced nummular dermatitis.<\/li>\n<\/ul>\n
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\n<\/div><\/div><\/div><\/div>\n
<\/span>Pre-treatment evaluation<\/span><\/h2>\nThe patient is evaluated to determine:<\/p>\n
\n- The disease is one that is expected to respond to medication.<\/li>\n
- The extent and severity of the disease is recorded.\n
\n- \nPASI<\/span> score for chronic plaque psoriasis\n<\/li>\n
- \nSCORE<\/span> or EASI<\/span> for atopic eczema\n<\/li>\n<\/ul>\n<\/li>\n
- The impact of the disease is recorded.\n
\n- \nDLQI<\/span> (dermatological quality of life index)<\/li>\n<\/ul>\n<\/li>\n
- The patient wishes to receive the medication and is expected to comply with the monitoring instructions.<\/li>\n
- Impact of patient comorbidities.\n