Chapter 48: Dermatologic Disorder Drug Therapy

Dermatologic Disorder Drug Therapy extensively covers the pathophysiology and management of acne vulgaris, detailing the role of Propionibacterium acnes and keratin plugs, and outlining treatment regimens that combine topical agents like benzoyl peroxide, retinoids (e.g., tretinoin, adapalene), and antibiotics with systemic therapies such as tetracyclines and isotretinoin, the latter requiring strict adherence to the iPLEDGE risk management program due to severe teratogenicity. The text examines psoriasis as a chronic autoimmune condition characterized by erythematous plaques, discussing a stepped-care approach involving topical corticosteroids of varying potencies, vitamin D analogs like calcipotriene, and systemic biologic response modifiers (BRMs) including TNF inhibitors (adalimumab, etanercept) and interleukin antagonists that target inflammatory cytokines. Significant attention is given to the treatment of verruca vulgaris (warts) caused by HPV using keratolytic agents like salicylic acid or cryotherapy, as well as the management of drug-induced dermatitis which can escalate to life-threatening conditions like Stevens-Johnson syndrome and toxic epidermal necrolysis. The summary also details therapeutic strategies for contact dermatitis (allergic and irritant), impetigo caused by Staphylococcus or Streptococcus species, and rosacea, alongside hair loss treatments such as minoxidil and finasteride for alopecia. Finally, the chapter addresses burn management, differentiating between thermal, electrical, and chemical burns, and describes the use of fluid resuscitation formulas (Parkland) and topical anti-infectives like silver sulfadiazine and mafenide acetate, while emphasizing preventative care through the use of broad-spectrum sunscreens to block UVA and UVB radiation.