Non-Steroidal Anti-Inflammatory Drugs Use in Dermatology

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) have anti-inflammatory, analgesic and antipyretic properties. NSAIDs mainly exert their effects by decreasing the synthesis of prostaglandins (PGs) via inhibition of cyclooxygenase (COX) enzymes. Arachidonic acid, is the precursor of COX mediated pathway, released by hydrolysis of membrane phospholipids. COX enzymes (COX-1 and COX-2) catalyze the conversion of arachidonic acid into PGs. Synthesized PGs exert their inflammatory effects by increasing vascular permeability, inducing vasodilation, and enhancing the inflammatory effects of histamine and bradykinin. PGs also mediate the central and peripheral nociceptive responses. Therefore, the therapeutic potential for inflammatory conditions and analgesic effect of NSAIDs comes from decreasing PGs synthesis. Various NSAIDs have been used in the treatment of a range of dermatoses in which inflammation plays an important role. The efficacy of NSAIDs in treating vasculitis, Sweet syndrome, eosinophilic pustular folliculitis and erythema nodosum was reported in several studies. Although not commonly used, topical NSAIDs are recommended to treat inflammatory acne lesions. Besides the anti-inflammatory properties, analgesic effects of NSAIDs are desired in dermatology to manage pain in many procedures performed by dermatologists and painful diseases. NSAIDs are effective for the management of mild to moderate acute postsurgical pain. As well as they were considered among the first-line treatments for hidradenitis suppurativa-associated nociceptive pain. Chemoprevention for skin cancer is the other potential therapeutic area of NSAIDs. NSAIDs are supposed to inhibit cutaneous carcinogenesis by both COX-dependent and non-dependent pathways. There are studies elucidating the effects of NSAIDs in reducing keratinocyte cancers. Topical diclofenac was reported to be effective for the treatment of actinic keratoses, common dysplastic lesions of keratinocytes. Chemotherapeutic potential might expand the use of these agents. In this chapter, these subjects regarding the use of NSAIDs in dermatology will be discussed. © 2021 by Nova Science Publishers, Inc. All rights reserved.