Assuntos
Carcinoma de Células Escamosas/cirurgia , Lúpus Eritematoso Discoide/complicações , Neoplasias Cutâneas/patologia , Administração Tópica , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Idoso , Antimaláricos/efeitos adversos , Antimaláricos/uso terapêutico , Inibidores de Calcineurina/administração & dosagem , Inibidores de Calcineurina/uso terapêutico , Carcinoma de Células Escamosas/radioterapia , Clofazimina/administração & dosagem , Clofazimina/uso terapêutico , Retinopatia Diabética/induzido quimicamente , Quimioterapia Combinada , Orelha/patologia , Humanos , Hansenostáticos/administração & dosagem , Hansenostáticos/uso terapêutico , Lúpus Eritematoso Discoide/tratamento farmacológico , Excisão de Linfonodo/métodos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tacrolimo/administração & dosagem , Tacrolimo/uso terapêutico , Resultado do TratamentoRESUMO
Discolorations of the skin, such as vitiligo, were recognized thousands of years ago. White spots caused by vitiligo and other disorders have caused significant social opprobrium to those disfigured by these pigmentary disorders, throughout history and still in the present day. Treatments have been desperately sought with only partial success. Recent advances suggest that vitiligo and other pigmentary disorders might soon be curable.
Assuntos
Corticosteroides/uso terapêutico , Inibidores de Calcineurina/uso terapêutico , Terapia PUVA/métodos , Vitiligo/terapia , Administração Cutânea , Anti-Helmínticos/uso terapêutico , Antimaláricos/uso terapêutico , Antimetabólitos Antineoplásicos/uso terapêutico , Catalase/uso terapêutico , Clofazimina/uso terapêutico , Fluoruracila/uso terapêutico , Ácido Fólico/uso terapêutico , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Quelina/uso terapêutico , Hansenostáticos/uso terapêutico , Levamisol/uso terapêutico , Terapia PUVA/história , Fenilalanina/uso terapêutico , Vitiligo/históriaRESUMO
INTRODUCTION: Synthetic drugs are prescribed for nearly all patients with systemic lupus erythematosus (SLE), a multisystem autoimmune disease, to ameliorate symptoms and positively influence outcome. While only 2 biologic agents have been approved for the treatment of SLE, synthetic drugs are still the mainstay of therapy in SLE. The highly variable and unpredictable course of SLE poses a challenge for physicians as to what drug(s) should be prescribed for which patient. AREAS COVERED: Previous and recent studies have evaluated several synthetic drugs in the treatment of SLE. This article reviews currently available evidence for the efficacy and safety of synthetic drugs in SLE and discusses future treatment perspectives. EXPERT OPINION: Hydroxychloroquine should be considered an anchor drug in SLE because of the multiple beneficial effects of this agent. When patients present with persistent disease activity despite hydroxychloroquine therapy or need higher dosages and/or prolonged use of glucocorticoids (GCs), additional immunosuppressants should be promptly prescribed. Based on available evidence, azathioprine and mycophenolate mofetil are the drugs of first choice. Determination of a 'safe' GC dose for chronic daily use is of major importance and should be subject of further studies in large patient populations.