What is new in dermatotherapy?

Present by : dr.
 INTRODUCTION

Dermatology is an ever‑expanding discipline with the discovery of new

entities daily
The pathogenesis of diseases better understood these days is
attributable to the research activities being conducted globally

Writer have summarized the newer medical therapeutic options for a

wide gamut of dermatological conditions with the proposed mechanism
of action of the molecule
 Apremilast
Mechanism of action: It is a phosphodiesterase inhibitor that binds to
phosphodiesterase‑IV and Toll‑like receptor‑4 in peripheral blood cells  reverses the
increased phosphodiesterase 4 activity of immune cells in atopic dermatitis and bringing a
decrease in cytokines released from T‑cells.

° It is used in Behcet’s disease, hidradenitis suppurativa, atopic dermatitis and recalcitrant

pyoderma gangrenosum
 Oral ulcers in Behcett’s disease  apremilast 30 mg twice daily for 12 weeks
 pyoderma gangrenosum  apremilast 30 mg twice daily was added to a regimen of oral
prednisone 7.5 mg daily and subcutaneous methotrexate 18 mg weekly, for 4 months.
 Beta Blockers

Mechanism of action:
Prevent the formation of keloids by activating extracellular kinase which
accelerates inflammatory cell migration and proliferation and inhibiting
apoptosis and have a role in the prevention of formation of keloids
 Biologics
(newer molecules)
 Intralesional bleomycin

Mechanism of action: It breaks the • It also inhibits the incorporation of

backbone of DNA by generating free thymidine into the DNA
radicals and also has a sclerosant
action on endothelial cells.

intralesional combination injection of Bleomycin with 5 mL of distilled water

triamcinolone, bleomycin and and then mixing 1 mL of the solution
bevacizumab was used in the with 2 mL of 2% lignocaine and finally
treatment of lymphangioma injecting with a 26G needle
circumscriptum of the tongue
 Topical Cetirizine
• Mechanism of action: Prostaglandin E and F favour hair growth and
prostaglandin D2 inhibits hair growth  levels of prostaglandin D2 synthetase are
elevated in the bald scalp when compared to the normal scalp.

• A pilot study in 85 patients (67 cases and 18 controls)  evaluate the efficacy of
topical cetirizine versus placebo in patients with androgenetic alopecia.

• Topical cetirizine was found to increase total hair density, terminal hair
density and diameter variation from T0 to T1.
 Chlorine dioxide

• Chlorine dioxide complex is nontoxic to human use and is an excellent

antiseptic and anti‑inflammatory product.
• the side effects are absent due to inactivation by an intracellular
defense mechanism. It is found to be an efficacious cleansing agent in
keratosis pilaris

Mechanism of action: neutralizes the reactive oxygen molecules and

degrades the intramolecular and intermolecular disulfide bonds that
stabilize the keratin, thereby acting as a keratolytic
 Gentamycin topical
Clascoterone cream
Crisaborole   hereditary
1% for acne
atopic dermatitis hypotrichosis of
vulgaris
scalp

Gentian violet  Glycopyrronium and

antibacterial, antifungal, sofpironium
antihelminthic, bromide gel 
antitrypasonomal, axillary
antiangiogenic, antitumor hyperhidrosis
Hepatitis B vaccine  treatments for warts  0.2 ml vaccine
every 2 weeks

Hydrogen peroxide  seborrheic keratosis  40% lotion

Lidocaine gel  peristomal dermatitis

Losartan  epidermolysis bullosa

Melatonin  atopic dermatitis  3 mg/day for 4 weeks

 Metformin topical 
Minocycline 
melasma  30 g of
topical minocycline
metformin powder with 4% and oral
70% alcohol abd minoxidil 5-100 mg
propylene glycol in 30%

Topical mupirocin
Narrow band ultraviolet B
 balanitis
 verruca plana  0.3
circumscripta
J/cm2
plasmacellularis

Normal saline
injection  steroid
induced atrophy
Molecules (newer) for hereditary angioedema

7
Regimens Ozenoxacin 1% cream applied twice daily dor 5 days
 impetigo

Ranitidine 5 mg/kg/day twice daily  molluscum

contagiosum

Topical rapamycin 1 g and calcitriol 1 g + petroleum

998 g twice daily for 24 weeks  tuberous sclerosis

Sarecycline 1.5 mg/kg/day  severe acne vulgaris

Serlopitant 5 mg once daily  psoriatic pruritus

Silymarin 140 mg/day  prevent rise of ALT AST in

patient that taking isoretinoin
Topical timolol 1-2 drops of timolol 0.5%  chronic,
recalcitrant fissures and erosions of hand eczema

Tofacitinib topical 5 mg to 10 mg twice daily 

alopecia areata and atopic dermatitid

Tranexamic acid (5%)  0.9% sodium chloride 

post acne erythema

Tranexamic acid 5% solution  Stevens-Johnson

syndrome/toxic epidermal necrolysis
Regimens Trifarotene cream  once daily at night  acne

Valacyclovir  1000 mg daily  zosteriform

mycosis fungoides

Zoliflodacin  2-3 g orally  gonorrhea

 Conclusion
° Writer have summarized the newer therapeutic options in
dermatological conditions.
° And have considered enumerating the newer uses of older
molecules; apart from enlisting the names and indications of
the recently approved molecules.
° However, in this article already mention that the
aforementioned options should be considered, only after
giving due importance to the availability, side‑effect profile
and the cost factor
THANKYOU