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Title: | Hydroxychloroquine in dermatology: New perspectives on an old drug. | Authors: | Chew C.Y.;Saracino A.M.;Nikpour M.;Mar A. | Monash Health Department(s): | Dermatology | Institution: | (Chew, Mar) Department of Dermatology, Monash Health, Clayton, VIC, Australia (Nikpour) The University of Melbourne at St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia (Saracino) Division of Medicine, Centre for Rheumatology and Connective Tissue Diseases, University College London at Royal Free Hospital London, London, United Kingdom | Issue Date: | 5-Jun-2020 | Copyright year: | 2020 | Publisher: | Blackwell Publishing | Place of publication: | Australia | Publication information: | Australasian Journal of Dermatology. 61 (2) (pp e150-e157), 2020. Date of Publication: 01 May 2020. | Journal: | Australasian Journal of Dermatology | Abstract: | Hydroxychloroquine is an age-old drug whose use as an immunomodulatory agent with a low side-effect profile continues to expand. We present a review of this drug including recently updated prescribing recommendations and a summary of its clinical application in dermatology. A maximum daily dose of 5.0 mg/kg based on actual body weight and no greater than 400 mg is advised in order to reduce the risk of retinopathy, which is potentially permanent and has an estimated prevalence of 7.5% at 5 years on standard dosing. Baseline ophthalmologic assessment followed by annual screening after 5 years is recommended; however, closer monitoring should be considered in the setting of existing retinopathy, a cumulative dose > 1000 g or renal dysfunction. Hydroxychloroquine is now considered to be safe in pregnancy, and routine glucose-6-phosphate dehydrogenase (G6PD) deficiency testing is not required. Smoking can significantly decrease its efficacy although the reason is still uncertain. Hydroxychloroquine appears to also demonstrate antineoplastic and cardioprotective benefits.Copyright © 2019 The Australasian College of Dermatologists | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/ajd.13168 | PubMed URL: | 31612996 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31612996] | ISSN: | 0004-8380 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/35375 | Type: | Review | Subjects: | drug absorption drug bioavailability drug contraindication drug efficacy drug metabolism drug safety erythema annulare centrifugum/si [Side Effect] erythema multiforme/si [Side Effect] eye examination gastrointestinal symptom/si [Side Effect] giant cell granuloma/dt [Drug Therapy] glioblastoma/dt [Drug Therapy] glucose 6 phosphate dehydrogenase deficiency granuloma annulare/dt [Drug Therapy] heart protection heartburn/si [Side Effect] human hyperpigmentation/si [Side Effect] hypertransaminasemia/si [Side Effect] hypoglycemia/si [Side Effect] immunomodulation irritability leukopenia/si [Side Effect] lichen (disease)/dt [Drug Therapy] lichen planus/dt [Drug Therapy] lichen sclerosus et atrophicus/dt [Drug Therapy] liver toxicity/si [Side Effect] lung cancer/dt [Drug Therapy] lupus vulgaris/dt [Drug Therapy] measles like rash/si [Side Effect] melanoma/dt [Drug Therapy] mood change morphea/dt [Drug Therapy] mucinosis/dt [Drug Therapy] multiple myeloma/dt [Drug Therapy] nausea/si [Side Effect] necrobiosis lipoidica/dt [Drug Therapy] nightmare/si [Side Effect] nonhuman outcome assessment pancreas cancer/dt [Drug Therapy] panniculitis/dt [Drug Therapy] patient monitoring pharmacodynamics photodermatosis/dt [Drug Therapy] porphyria cutanea tarda/dt [Drug Therapy] practice guideline pregnancy prescription pruritus/si [Side Effect] psoriasis/si [Side Effect] rash/si [Side Effect] retina maculopathy/si [Side Effect] retinopathy/si [Side Effect] review risk benefit analysis risk reduction sarcoma/dt [Drug Therapy] side effect/si [Side Effect] skin contusion/si [Side Effect] skin sarcoidosis/dt [Drug Therapy] smoking solid malignant neoplasm/dt [Drug Therapy] Stevens Johnson syndrome/si [Side Effect] systemic lupus erythematosus/dt [Drug Therapy] systemic sclerosis/dt [Drug Therapy] toxic epidermal necrolysis/si [Side Effect] treatment response urticaria/si [Side Effect] vasculitis/dt [Drug Therapy] visual impairment/si [Side Effect] vomiting/si [Side Effect] cyclosporine/it [Drug Interaction] digoxin/it [Drug Interaction] glucose 6 phosphate dehydrogenase/ec [Endogenous Compound] *hydroxychloroquine/ae [Adverse Drug Reaction] *hydroxychloroquine/it [Drug Interaction] *hydroxychloroquine/dt [Drug Therapy] *hydroxychloroquine/pk [Pharmacokinetics] *hydroxychloroquine/pd [Pharmacology] methotrexate/it [Drug Interaction] follicular mucinosis/dt [Drug Therapy] lichen planopilaris/dt [Drug Therapy] reticular erythematous mucinosis/dt [Drug Therapy] urticarial vasculitis/dt [Drug Therapy] laboratory test abdominal distension/si [Side Effect] acute generalized exanthematous pustulosis/si [Side Effect] agranulocytosis/si [Side Effect] alopecia/si [Side Effect] alopecia areata/dt [Drug Therapy] anorexia/si [Side Effect] antineoplastic activity antiphospholipid syndrome/dt [Drug Therapy] antithrombotic activity aplastic anemia/si [Side Effect] blood toxicity/si [Side Effect] chronic urticaria/dt [Drug Therapy] *dermatology dermatomyositis/dt [Drug Therapy] diarrhea/si [Side Effect] DRESS syndrome/si [Side Effect] drug absorption drug bioavailability drug contraindication drug efficacy drug metabolism drug safety erythema annulare centrifugum erythema multiforme eye examination gastrointestinal symptom giant cell granuloma glioblastoma glucose 6 phosphate dehydrogenase deficiency granuloma annulare heart protection heartburn hyperpigmentation hypertransaminasemia hypoglycemia immunomodulation irritability leukopenia lichen (disease) lichen planus lichen sclerosus et atrophicus liver toxicity lung cancer lupus vulgaris measles like rash melanoma mood change morphea mucinosis multiple myeloma nausea necrobiosis lipoidica nightmare pancreas cancer panniculitis patient monitoring pharmacodynamics photodermatosis porphyria cutanea tarda practice guideline pregnancy prescription pruritus psoriasis rash retina maculopathy retinopathy risk benefit analysis risk reduction sarcoma skin contusion skin sarcoidosis smoking solid malignant neoplasm Stevens Johnson syndrome systemic lupus erythematosus systemic sclerosis toxic epidermal necrolysis urticaria vasculitis visual impairment vomiting cyclosporine/it [Drug Interaction] digoxin/it [Drug Interaction] glucose 6 phosphate dehydrogenase hydroxychloroquine [Adverse Drug Reaction] hydroxychloroquine/it [Drug Interaction] hydroxychloroquine methotrexate/it [Drug Interaction] follicular mucinosis lichen planopilaris reticular erythematous mucinosis urticarial vasculitis laboratory test abdominal distension acute generalized exanthematous pustulosis agranulocytosis alopecia alopecia areata anorexia antineoplastic activity antiphospholipid syndrome antithrombotic activity aplastic anemia blood toxicity chronic urticaria dermatology dermatomyositis diarrhea DRESS syndrome chronic urticaria / drug therapy *dermatology dermatomyositis / drug therapy diarrhea / side effect DRESS syndrome / side effect drug absorption drug bioavailability drug contraindication drug efficacy drug metabolism drug safety erythema annulare centrifugum / side effect erythema multiforme / side effect eye examination gastrointestinal symptom / side effect giant cell granuloma / drug therapy glioblastoma / drug therapy glucose 6 phosphate dehydrogenase deficiency granuloma annulare / drug therapy heart protection heartburn / side effect human hyperpigmentation / side effect hypertransaminasemia / side effect hypoglycemia / side effect immunomodulation irritability laboratory test leukopenia / side effect lichen (disease) / drug therapy lichen planus / drug therapy lichen sclerosus et atrophicus / drug therapy liver toxicity / side effect lung cancer / drug therapy lupus vulgaris / drug therapy measles like rash / side effect melanoma / drug therapy mood change morphea / drug therapy mucinosis / drug therapy multiple myeloma / drug therapy nausea / side effect necrobiosis lipoidica / drug therapy nightmare / side effect nonhuman outcome assessment pancreas cancer / drug therapy panniculitis / drug therapy patient monitoring pharmacodynamics photodermatosis / drug therapy porphyria cutanea tarda / drug therapy practice guideline pregnancy prescription acute generalized exanthematous pustulosis / side effect psoriasis / side effect rash / side effect retina maculopathy / side effect retinopathy / side effect Review risk benefit analysis risk reduction sarcoma / drug therapy side effect / side effect skin contusion / side effect skin sarcoidosis / drug therapy smoking solid malignant neoplasm / drug therapy Stevens Johnson syndrome / side effect systemic lupus erythematosus / drug therapy systemic sclerosis / drug therapy toxic epidermal necrolysis / side effect treatment response urticaria / side effect vasculitis / drug therapy visual impairment / side effect vomiting / side effect abdominal distension / side effect pruritus / side effect agranulocytosis / side effect alopecia / side effect alopecia areata / drug therapy anorexia / side effect antineoplastic activity antiphospholipid syndrome / drug therapy antithrombotic activity aplastic anemia / side effect blood toxicity / side effect |
Type of Clinical Study or Trial: | Review article (e.g. literature review, narrative review) |
Appears in Collections: | Articles |
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