Topical use of systemic drugs in dermatology: a comprehensive review

Abstract

Background: Topical use of systemic agents to treat cutaneous disorders is widely applied. However, there is a lack of articles summarizing the relevant literature in a systematic way.

Objective: We sought to review the published literature regarding topical use of systemic drugs that were categorized according to their mode of actions. Only drugs that are not yet commercially available in a topical preparation are included.

Methods: A PubMed search was performed, using as key words "topical," "extemporaneous," "compounding," and names of each generic drug, to identify all clinical reports (1966-2009).

Results: Although many systemic drugs are used topically, randomized controlled trials were limited to a few agents.

Limitation: Many of the reports consist only of small case series or are anecdotal in nature. As the level of evidence is limited, larger prospective trials are needed before firm conclusions can be drawn.

Conclusion: Extemporaneous compounding helps physicians to individualize treatment to the patient's specific needs and to create topical preparations that are not otherwise commercially available. However, comparative effectiveness studies are needed to determine whether or not topical use of systemic therapeutics is more beneficial than existing therapies.