Chapter 56: Dermatologic Drugs

The skin functions as a protective barrier while facilitating temperature regulation, sensory perception, vitamin D synthesis, and transdermal drug absorption, making understanding its physiology essential for rational drug selection. The chapter systematically covers major therapeutic categories beginning with antibacterial agents used to prevent and treat skin infections, including topical options effective against methicillin-resistant organisms and burn wound management. Acne treatment integrates multiple drug classes from keratolytic agents and topical antibiotics to systemic retinoids with strict monitoring protocols and pregnancy prevention measures. Antifungal medications address both superficial and deeper dermatophytic infections through various mechanisms of action, while antiviral agents target herpesvirus and other viral skin manifestations. Inflammatory and pruritic conditions benefit from topical anesthetics, antihistamines, and corticosteroid therapy, with special attention to chronic diseases like psoriasis managed through vitamin D analogs, retinoid therapy, and biologic immunomodulators targeting specific inflammatory pathways. The chapter addresses ectoparasitic infestations through insecticidal and pediculicidal agents, hair growth disorders via topical stimulants, and malignant skin conditions through topical chemotherapy and photodynamic approaches. Wound management encompasses enzymatic debridement, antimicrobial dressing materials, and appropriate cleansing solutions that balance infection control with tissue preservation. Nursing care emphasizes comprehensive skin assessment, appropriate specimen collection for microbial identification, vigilant monitoring for adverse effects including photosensitivity and systemic absorption, patient education on proper application techniques, infection prevention strategies, and counseling regarding teratogenic risks with certain agents. Patient compliance relies on understanding the chronic nature of many skin conditions, consistent sun protection practices, self-surveillance for malignant changes, and realistic expectations regarding therapeutic timelines.