Koranda F C
J Am Acad Dermatol. 1981 Jun;4(6):650-5. doi: 10.1016/s0190-9622(81)70065-3.
The antimalarials, chloroquine, hydroxychloroquine, and quinacrine, are used primarily for malaria; but they can be beneficial for cutaneous lupus erythematosus (LE), polymorphous light eruption, solar urticaria, and porphyria cutanea tarda. Antimalarials bind to deoxyribonucleic acid (DNA) which prevents DNA and ribonucleic acid (RNA) polymerase reactions and DNA heat inactivation; and they inhibit the LE cell phenomenon, antinuclear antibody reactions, and suppress lymphocyte transformation. By competing with calcium ion, they stabilize membranes and have an anesthetic effect. Their anti-inflammatory potential is due to their inhibition of hydrolytic enzymes, stabilization of lysosomes, interference with prostaglandin synthesis, blocking of chemotaxis, and antagonism of histamine responses. The antimalarials have no sunscreening properties. The most common toxic effects are cutaneous pigmentation, nausea, vomiting, diarrhea, mild ileus, and cycloplegia. There has been a reluctance to use chloroquine and hydroxychloroquine because of the possibility of retinopathy. However, if the "safe" daily dose limit of chloroquine, 2 mg per pound of body weight, and of hydroxychloroquine, 3.5 mg per pound of body weight, is followed, the chance of retinopathy is slight. Quinacrine does not cause retinopathy, but it has more cutaneous side effects than the other two agents.
抗疟药，如氯喹、羟氯喹和奎纳克林，主要用于治疗疟疾；但它们对皮肤红斑狼疮（LE）、多形性日光疹、日光性荨麻疹和迟发性皮肤卟啉症也可能有益。抗疟药与脱氧核糖核酸（DNA）结合，可防止DNA和核糖核酸（RNA）聚合酶反应以及DNA热失活；它们还能抑制LE细胞现象、抗核抗体反应，并抑制淋巴细胞转化。通过与钙离子竞争，它们可稳定细胞膜并具有麻醉作用。其抗炎潜力源于对水解酶的抑制、溶酶体的稳定、对前列腺素合成的干扰、趋化作用的阻断以及对组胺反应的拮抗。抗疟药没有防晒特性。最常见的毒性作用是皮肤色素沉着、恶心、呕吐、腹泻、轻度肠梗阻和睫状肌麻痹。由于存在视网膜病变的可能性，人们一直不愿使用氯喹和羟氯喹。然而，如果遵循氯喹每磅体重2毫克、羟氯喹每磅体重3.5毫克的“安全”日剂量限制，发生视网膜病变的可能性很小。奎纳克林不会引起视网膜病变，但它比其他两种药物有更多的皮肤副作用。
