Therapeutic Potential of Isoniazid in Inflammatory Skin Diseases: A Review

Isoniazid (INH), a well-established anti-tuberculosis agent, has recently gained increasing interest because of its anti-inflammatory and immunomodulatory properties. This review is intended to summarize the mechanistic basis of INH in inflammatory skin disorders and to assess its potential clinical applicability. However, most evidence discussed here derives from preclinical studies and remains largely hypothesis-generating.

A literature search was performed in the CNKI and PubMed databases.

The anti-inflammatory activity of INH is mediated through several pathways, including regulation of the ROS-PPARγ-NF-κB/AP-1 axis, suppression of NLRP3 inflammasome activation, and modulation of the Th1/Th2 balance. Therapeutic potential has been observed in conditions such as atopic dermatitis, psoriasis, urticaria, and rosacea, particularly among patients with latent tuberculosis infection or those undergoing biologic therapy, supporting its dual "anti-inflammatory-antituberculosis" value.

INH demonstrates a multi-target mode of action and distinct dual clinical advantages in the management of inflammatory skin diseases, rendering it especially relevant for resource-constrained settings and selected patient populations. Additional clinical investigations remain necessary to determine the optimal treatment strategy and to further establish its safety profile. However, clinical evidence remains limited and further prospective studies are needed.