Topical Use of Systemic Drugs in Dermatology: A Comprehensive Review

The document provides a comprehensive review of the literature on the topical use of systemic drugs in dermatology, with a focus on drugs not commercially available in topical forms. The authors found that while there is potential for extemporaneous compounding to create individualized treatments, the evidence is largely based on small case series or anecdotal reports, and there is a lack of randomized controlled trials. They identified several systemic drugs with promising topical applications, including granulocyte-CSF for Behçet disease ulcers, phenytoin for lichen planus, clonazepam for stomatodynia, and others for conditions like psoriasis, leukoplakia, lupus erythematosus, and various infections. However, the review calls for larger prospective trials and comparative effectiveness studies to establish the benefits of these treatments over existing therapies and to address considerations such as drug properties, stability, sterility, systemic absorption, and legal risks. The authors aim to stimulate interest in the development of new topical applications for systemic drugs.