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Use of calcium channel blockers in dermatology: a narrative review
Yang Lo1, Lian-Yu Lin2, Tsen-Fang Tsai3
1Department of Dermatology, Cathay General Hospital, Taipei, Taiwan.
Insights
Calcium channel blockers (CCB) show potential in treating dermatological conditions like pernio and anal fissures due to vasodilation. However, mucocutaneous adverse reactions such as gingival hyperplasia and phototoxicity necessitate further research into safe CCB applications.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Calcium channel blockers (CCB) are widely used for cardiovascular conditions.
- Evidence for CCB in dermatology is largely anecdotal, based on case reports and small series.
- This review explores therapeutic uses and mucocutaneous adverse reactions of CCB in dermatology.
Purpose of the Study:
- To review the therapeutic applications of CCB in dermatology.
- To examine the mucocutaneous adverse effects associated with CCB administration.
- To discuss the potential of topical CCB formulations.
Main Methods:
- Literature review of existing studies on CCB in dermatology.
- Analysis of reported therapeutic uses and adverse events.
- Evaluation of expert opinions on CCB efficacy and safety.
Main Results:
- CCB are utilized for conditions like pernio, anal fissures, facial wrinkles, and leiomyoma, primarily due to vasodilatory and muscle-relaxant properties.
- Other proposed mechanisms support CCB use in calcinosis, keloids, pressure ulcers, and fibromatosis.
- Mucocutaneous adverse effects include gingival hyperplasia, phototoxicity, eczema, psoriasis, and potential skin cancer risk.
Conclusions:
- CCB possess therapeutic potential in dermatology, but evidence is limited.
- Topical CCB may offer an alternative with fewer systemic side effects, though formulations and evidence are lacking.
- Understanding CCB's role in calcium homeostasis, photoinstability, and immunosuppression is crucial for managing adverse events.
Abstract:
Introduction: Calcium channel blockers (CCB) are commonly used for cardiovascular diseases. The evidence supporting the use of CCB in dermatology is mostly anecdotal and limited to case reports or small case series.Areas covered: This review article is divided into two parts. The first part discusses the therapeutic use of CCB in dermatology. The second part focuses on mucocutaneous adverse reactions due to the administration of CCB.Expert opinion: The use of CCB in dermatology is mainly based on its properties as a vasodilator and the inhibition of muscle contractions, such as pernio, anal fissures, facial wrinkles, and painful leiomyoma. However, there remain other modes of action to explain its clinical use in calcinosis, keloid, pressure ulcer, and fibromatosis. Compared to oral CCB, the lack of systemic side effects would make topical use of CCB an attractive alternative in the treatment of skin diseases, but the evidence for topical CCB is still limited, and there is a lack of standardized topical formulation. The main mucocutaneous adverse effects of CCB include gingival hyperplasia, phototoxicity, eczema, psoriasis and risk of skin cancers. Plausible factors for these adverse events include CCB's photoinstability, aldosterone synthesis inhibition, disturbed calcium homeostasis and immunosuppressive properties.
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