Practical Management of Immunosuppressants in Dermatology

• Published in: Actas dermo-sifiliográficas (English ed.) 2018-01, Vol.109 (1), p.24
• Main Authors: Leis-Dosil, V M, Prats-Caelles, I
• Format: Article
• Language: eng ; spa
• Subjects: Adrenal Cortex Hormones - therapeutic use; Antirheumatic Agents - therapeutic use; Autoimmune Diseases - drug therapy; Autoimmune Diseases - immunology; Contraindications, Drug; Dermatitis - drug therapy; Dermatitis - immunology; Dermatology - methods; Drug Monitoring; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Skin Diseases - drug therapy; Skin Diseases - immunology; Vaccination
• ISSN: 1578-2190
• DOI: 10.1016/j.ad.2017.05.005

The treatment of inflammatory and autoimmune diseases is challenging because of their frequency and complexity. Treatment of these diseases is based on the suppression of the patient's immune system using corticosteroids, corticosteroid-sparing immunosuppressive agents, and biologic drugs, making an understanding of the management of immunosuppressive therapy essential. Before an immunosuppressive agent is prescribed, a study must be carried out to identify contraindications, detect latent infections, and determine the most appropriate dose. During treatment, regular monitoring is required to detect adverse effects. The clinician must be familiar with the time lag between start of treatment and onset of the immunosuppressive effect as well as the maximum recommended duration of treatment and cumulative dose for each drug. As dermatologists we are accustomed to using these immunosuppressive agents, but we should have a good knowledge of the guidelines for their use and the monitoring required in each case if we are to reduce variability and avoid potentially serious adverse effects.