Drug name | Mechanism | Risk of NMSC | Dermatologic side effects |
Systemic glucocorticoids | Inhibit antigen presentation, induce lymphocyte toxicity, alter cytokine production | + | Acne, striae, skin fragility, ecchymosis |
Azathioprine | Inhibits purine synthesis | ++++ | Hypersensitivity reaction including urticaria, maculopapular and vasculitic eruptions |
Mycophenolate mofetil | Inhibits guanine nucleotide synthesis | +++ | Nonspecific rash |
Cyclosporine | Calcineurin inhibitor Decreases T cell activation and IL-2 production | ++++ | Hirsutism, sebaceous hyperplasia, gingival hyperplasia |
Tacrolimus | Calcineurin inhibitor | +++ | Alopecia |
Sirolimus | Inhibits mammalian target of rapamycin Abrogates IL-2 signal transduction | + (decreased skin cancer in clinical trials) | Impaired wound healing, acne/folliculitis, edema |
Everolimus | Inhibits mammalian target of rapamycin Abrogates IL-2 signal transduction | + (similar to sirolimus) | Mouth ulcers, stomatitis |
Belatacept[1] | Selective T cell costimulation blockade | +++ (similar to or slightly less than cyclosporine)[2] | Alopecia, impaired wound healing, edema |
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