| Popis: |
Systemic therapy is indicated for the treatment of skin disorders when the extent or severity of the disease would make topical therapy impractical or insufficiently effective, or because the drug used is not active when topically administered. As with any treatment, the risks and benefits must be carefully evaluated and therapeutic choices made in collaboration with the patient. Available treatments generally control rather than cure, early intervention in the course of chronic skin disease does not appear to alter long-term prognosis, and virtually all drugs are associated with toxicity, particularly with long-term use. Many of the drugs used in standard practice lack a robust evidence base and efficacy is unpredictable, particularly in rare skin diseases. Assessment of treatment efficacy can be difficult because there are no surrogate blood markers to indicate disease response, so careful clinical assessment of skin involvement is essential, with measures of quality of life. A wide variety of agents are prescribed in dermatology. In some situations, the drugs and doses are standard. However, many drugs are used in unconventional ways, or special consideration must be given to the disease and treatment modified accordingly. There are also many unusual drugs that are used for rare and/or recalcitrant disease. Thus, with the exception of acne, certain infections and type I allergic skin disease, systemic drug therapy in dermatology tends to be used in more severe or rare diseases, using potentially toxic or unusual drugs, and often requires specialized prescribing expertise to achieve optimal therapeutic outcomes. |
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