Cardiometabolic Associations of Dermatological Treatments. Part I: Systemic Therapies

Systemic treatments for common dermatological conditions, including psoriasis, hair loss, and onychomycosis, may be associated with cardiometabolic toxicities or protective effects. Increased awareness of associations between these dermatological treatments and cardiovascular and metabolic health (termed collectively cardiometabolic health) is needed for proactive management of patients with increased risk of cardiovascular diseases. Preventive medications may be indicated with certain treatments. Multidisciplinary efforts between dermatologists, cardiologists, endocrinologists, rheumatologists, oncologists, and primary care physicians may help reduce the risk of major adverse cardiovascular events. In Part I of this two-part continuing medical education series, we provide updates regarding the potential impact on development or worsening of cardiometabolic diseases from traditional systemic treatments, including retinoids/rexinoids, anthracyclines, antifungals, oral minoxidil, methotrexate, ultraviolet phototherapy, and colchicine. We also describe mechanisms of actions impacting cardiometabolic diseases, as well as provide practical recommendations for workup and monitoring in dermatological patients.