New concepts in antimalarial use and mode of action in dermatology.
Although chloroquine, hydroxychloroquine and quinacrine were originally developed for the treatment of malaria, these medications have been used to treat skin disease for over 50 years. Recent clinical data have confirmed the usefulness of these medications for the treatment of lupus erythematosus. Current research has further enhanced our understanding of the pharmacologic mechanisms of action of these drugs involving inhibition of endosomal toll-like receptor (TLR) signaling limiting B cell and dendritic cell activation. With this understanding, the use of these medications in dermatology is broadening. This article highlights the different antimalarials used within dermatology through their pharmacologic properties and mechanism of action, as well as indicating their clinical uses. In addition, contraindications, adverse effects, and possible drug interactions of antimalarials are reviewed.
Kalia
Sunil
S
Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada.
Dutz
Jan P
JP
D000818:Animals; D017951:Antigen Presentation / Q000187:drug effects; D000962:Antimalarials / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004347:Drug Interactions; D006801:Humans; D015227:Lipid Peroxidation / Q000187:drug effects; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D017119:Porphyria Cutanea Tarda / Q000188:drug therapy; D011565:Psoriasis / Q000188:drug therapy; D012871:Skin Diseases / Q000188:drug therapy*; D051193:Toll-Like Receptors / Q000037:antagonists & inhibitors
D000962:Antimalarials; D051193:Toll-Like Receptors