When to consider systemic therapy in dermatology?
- When topical drug delivery does not reach the target tissue.
e.g. onychomycosis (fungal nail infection)
- When the disease has systemic sequelae and systemic treatment is needed.
e.g. cutaneous disease in systemic lupus erythematosus
e.g. bacterial skin infection in a patient with valvular heart disease
- When topical therapy is ineffective and systemic therapy is more effective.
e.g. severe psoriasis
e.g. severe eczema
e.g. severe blistering disease
- When the cutaneous disease is extensive making topical therapy inconvenient (provided
that systemic therapy is not more toxic than topical treatment)
e.g. extensive fungal infection