Dermato-Venereology (Skin/VD) Center, Sehgal Nursing Home, Panchwati, Delhi, India.
J Dermatolog Treat. 2013 Apr;24(2):89-95. doi: 10.3109/09546634.2011.595383. Epub 2011 Jul 31.
Leflunomide, an isoxazole derivative, is a disease-modifying antirheumatic drug. It has successfully been used for the treatment of rheumatoid arthritis as a feasible alternative to methotrexate. Recently, leflunomide has been used in certain dermatologic conditions. Medline/PubMed search revealed only 201 articles of its application in dermatologic conditions, of which 21 were relevant for inclusion. Prime mode of action of leflunomide is through the inhibition of dihydroorotate dehydrogenase, a key enzyme in the de novo pyrimidine synthesis pathway used by lymphocytes for clonal expansion. The current level of evidence and strength of recommendation suggest its use in psoriasis and psoriatic arthritis. However, the use of leflunomide in severe atopic dermatitis, systemic lupus erythematosus, Wegener's granulomatosis, primary Sjögren's syndrome, bullous pemphigoid, dermatomyositis, sarcoidosis and systemic sclerosis still requires further evaluation.
来氟米特，一种异噁唑衍生物，是一种疾病修饰抗风湿药物。它已成功用于类风湿关节炎的治疗，作为甲氨蝶呤的可行替代药物。最近，来氟米特已用于某些皮肤科疾病。Medline/PubMed 搜索仅显示其在皮肤科疾病中的应用有 201 篇文章，其中 21 篇相关文章符合纳入标准。来氟米特的主要作用模式是通过抑制二氢乳清酸脱氢酶，该酶是淋巴细胞用于克隆扩增的嘧啶从头合成途径中的关键酶。目前的证据水平和推荐强度表明其可用于治疗银屑病和银屑病关节炎。然而，来氟米特在严重特应性皮炎、系统性红斑狼疮、韦格纳肉芽肿、原发性干燥综合征、大疱性类天疱疮、皮肌炎、结节病和系统性硬化症中的应用仍需要进一步评估。
