Use of calcium channel blockers in dermatology: a narrative review

ABSTRACT

Introduction: Calcium channel blockers (CCB) are commonly used for cardiovascular diseases. The evidence supporting the use of CCB in dermatology is mostly anecdotal and limited to case reports or small case series.

Areas covered: This review article is divided into two parts. The first part discusses the therapeutic use of CCB in dermatology. The second part focuses on mucocutaneous adverse reactions due to the administration of CCB.

Expert opinion: The use of CCB in dermatology is mainly based on its properties as a vasodilator and the inhibition of muscle contractions, such as pernio, anal fissures, facial wrinkles, and painful leiomyoma. However, there remain other modes of action to explain its clinical use in calcinosis, keloid, pressure ulcer, and fibromatosis. Compared to oral CCB, the lack of systemic side effects would make topical use of CCB an attractive alternative in the treatment of skin diseases, but the evidence for topical CCB is still limited, and there is a lack of standardized topical formulation. The main mucocutaneous adverse effects of CCB include gingival hyperplasia, phototoxicity, eczema, psoriasis and risk of skin cancers. Plausible factors for these adverse events include CCB’s photoinstability, aldosterone synthesis inhibition, disturbed calcium homeostasis and immunosuppressive properties.

KEYWORDS:

• Calcium channel blockers
• dermatology
• treatment
• cutaneous reaction
• adverse drug reaction

Article highlights

• Calcium channel blocker (CCB) is one of the treatment options for calcinosis cutis, Raynaud’s phenomenon and chilblain lupus erythematosus.

• Case reports exist regarding the use of CCB for atrophie blanche, facial wrinkle, fibromatosis and urticaria. But more convincing data are still needed to prove the efficacy.

• Mucocutaneous adverse drug reaction from CCB is usually mild, including hyperpigmentation, chronic eczematous eruption, lichenoid drug eruption, fixed drug eruption, psoriasiform eruption, subacute cutaneous lupus erythematosus, leukocytoclastic vasculitis, and pseudolymphoma.

Declaration of interest

T.F. Tsai has declared conducting clinical trials or receiving honoraria for serving as a consultant for AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Galderma, GSK‐Stiefel, Janssen‐Cilag, Leo‐Pharma, Merck, Novartis, Pfizer and Serono International SA (now Merck Serono International). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded