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Infusions

Infusions

Antibiotics: these are substances that either eliminate or inhibit the growth of microorganisms. Several classifications of microorganisms exist, with specific antibiotics targeting each class.

Antibacterials: these work by inhibiting several components of bacterial organisms, either directly killing them (bactericidal) or inhibiting their proliferation (bacteriostatic). All antibacterial infusions are used for serious skin or wound infections. The classes include Penicillins (Penicillin G, Nafcillin, Ampicillin, Piperacillin and Ticarcillin), Cephalosporins (Cefazolin, Cefotetan, Ceftazidime, Ceftriaxone and Cefepime), Carbapenems (Imipenem, meropenem, ertapenem), the monobactam Aztreonam, Vancomycin, Fluoroquinolones (Cipro-, Levo-, Moxi- and O-floxacin), Tetracyclines (Doxy- and Mino-cycline), and several others (Bactrim, Clindamycin, Linezolid, Metronidazole, Tigecycline and newer lipoglycopeptides ending in –vancin). Sometimes these can be used as at home therapy for skin infections.

Antifungals: most of these work by disrupting the cell wall either directly or its synthesis, with two exceptions. Several medications are available for intravenous use and treat serious fungal infections. Voriconazole is particularly common to dermatologists for causing significant photosensitivity and skin cancer. Other’s include amphotericin B, caspofungin and micafungin. Most of these medications are used in the hospital setting.

Antivirals: these work by destroying virus (viricidal) in severe outbreaks of human herpes virus infections. First-line options include Acyclovir and Ganciclovir, while Foscarnet and Cidofovir are two alternative treatments for drug-resistant herpes infections, usually in the immunocompromised.

Steroids: intravenous corticosteroids (ICS) are a life-saving therapeutic option for severe flares of several inflammatory skin conditions such as auto-immune connective tissue disease (lupus), vasculitis (blood vessel inflammation), pyoderma gangrenosum and several blistering conditions (pemphigus, pemphigoid). This list usually does not include atopic dermatitis/eczema or psoriasis, as these conditions can worsen after treatment ends. These are highly specialized medications that are usually administered in a hospital setting.

Immuno-Suppressives

Methotrexate: discovered over 60 years ago, methotrexate has both immunosuppressive and chemotherapeutic properties making it suitable for treatment of numerous inflammatory skin conditions at appropriate doses. Used by rheumatologists for several arthritis-associated conditions and oncologists for several malignancies, dermatologists have experience with this in cutaneous malignancies (Sezary syndrome) and numerous inflammatory skin diseases (Psoriasis, Atopic Dermatitis, Blistering skin diseases, autoimmune skin diseases, blood vessel inflammatory diseases and many others). Make an appointment today to discuss this beneficial treatment option.

Cyclosporine: originally discovered to be an anti-fungal medication in the 1970’s, this small molecule has potent immunosuppressive properties making it effective for several inflammatory skin diseases. While FDA-approved for psoriasis only, it has shown off-label efficacy in numerous skin diseases including blistering (bullous dermatoses), autoimmune connective tissue disease, inflammatory alopecia, dermatitis, hives (urticaria) and many others. A thorough evaluation by your advanced dermatology medical provider can determine if this therapy is right for you.

Remicade: in the class of anti-TNF’s, remicade (also known as Infliximab) is considered the most potent of it’s kind. It is usually given as an infusion over several hours and works by blocking the molecule tumor necrosis factor-alpha, which is important in systemic and skin inflammation. It has efficacy in treatment of psoriasis and other inflammatory conditions ( ). Make a call today to discuss if this treatment is right for you.

Rituxan: also known as rituximab, this novel therapy targets mature B-cells that are responsible for several skin conditions including blistering (bullous), autoimmune connective tissue, Graft-versus-host-disease, vasculitis (blood vessel inflammation) and cutaneous B-cell lymphoma. Given as a set of two infusions spaced out by 2 weeks, if the 1st infusion is well tolerated can be performed at an outpatient setting. When severe cases or flares of the above mentioned conditions are not controlled or pose severe life-limiting course, rituxan therapy can be a miracle. Only specialized providers are capable of administering this medication, so ask about it with your advanced dermatology medical provider at your appointment.

IVIg: this large collection of purified human-derived antibodies (molecules important in the body’s immune system defense) has immunomodulating effects systemically to help treat a host of difficult-to-treat skin conditions. Blistering disease (bullous dermatoses), autoimmune connective tissue disease, vasculitis (blood vessel inflammation), inflammatory skin diseases (including hives and eczema) and other skin conditions can benefit from this therapeutic option. Usually administered in the hospital, this specialized therapy can be life-saving to patients who suffer with their skin conditions.