Actinic Prurigo Medication

Updated: May 09, 2017
  • Author: Juan Pablo Castanedo-Cazares, MD, MSc; Chief Editor: Dirk M Elston, MD  more...
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Medication

Medication Summary

The primary component of treatment is avoiding sun exposure. However, oral and topical corticosteroids are frequently used for short periods. Thalidomide is used, either alone or with topical corticosteroids, for resistant or multiple-relapse cases.

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Immunosuppressant agents

Class Summary

These agents inhibit key steps responsible for initiating immune activity.

Thalidomide (Thalomid)

Thalidomide is an immunomodulatory agent that may suppress activated lymphocytes or prevent their activation. It also down-regulates excessive production of tumor necrosis factor-alpha and selected cell-surface adhesion molecules involved in leukocyte migration.

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Corticosteroids

Class Summary

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

Prednisone (Orasone, Meticorten, Sterapred, Deltasone)

Prednisone is an immunosuppressant for the treatment of autoimmune disorders; it may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Prednisone stabilizes lysosomal membranes and suppresses lymphocytes.

Betamethasone topical (Diprolene, Maxivate, Alphatrex)

Betamethasone topical is for inflammatory dermatoses responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability. It affects the production of lymphokines and has an inhibitory effect on Langerhans cells.

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Antimalarial agents

Class Summary

These agents are used for their anti-inflammatory and photoprotective effects.

Hydroxychloroquine (Plaquenil)

Hydroxychloroquine exerts anti-inflammatory activity by suppressing lymphocyte transformation and may have photoprotective effect. Use in actinic prurigo requires small doses once a day for long periods.

Chloroquine phosphate (Aralen Phosphate)

Chloroquine phosphate inhibits chemotaxis of eosinophils and locomotion of neutrophils, and it impairs complement-dependent antigen-antibody reactions. It may also have a photoprotective effect.

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Ophthalmics, Other

Class Summary

Topical cyclosporine is used in resistant cases of conjunctivitis and/or pseudopterygium.

Cyclosporine ophthalmic (Restasis)

Cyclosporine ophthalmic is used to relieve dry eyes caused by suppressed tear production secondary to ocular inflammation. It is thought to act as a partial immunomodulator. The exact mechanism of action is not known.

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