Statins: novel additions to the dermatologic arsenal?

• Published in: Experimental dermatology Vol. 13; no. 6; pp. 337 - 339
• Main Author: Namazi, M. R.
• Format: Journal Article
• Language: English
• Published: Oxford, UK; Malden, USA Munksgaard International Publishers 01-06-2004; Blackwell
• Subjects: alopecia areata; Biological and medical sciences; Bullous diseases of the skin; Dermatology; erythema multiforme; Hair and nails disorders; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; lichen planus; Medical sciences; mycosis fungoides; psoriasis; Psoriasis. Parapsoriasis. Lichen; Skin Diseases - drug therapy; subacute cutaneous lupus erythematosus; vitiligo; Bullous dermatosis; Skin disease; Autoimmune disease; Review; Lichen planus; Peripheral T cell lymphoma; Hair (head); Vitiligo; Lymphoproliferative syndrome; Systemic disease; Human; Hair; Immunopathology; Connective tissue disease; Pigmentation disorder; Psoriasis; Dermatology; Erythema multiform; Mycosis fungoides; Subacute cutaneous lupus erythematosus; Malignant hemopathy; Statin derivative; Non Hodgkin lymphoma; erythema multiforme; Alopecia areata; Chemotherapy; Cutaneous hematologic disease; Treatment
• ISSN: 0906-6705; 1600-0625
• DOI: 10.1111/j.0906-6705.2004.00208.x

:  The 3‐hydroxy‐3‐methylglutaryl coenzyme A (HMG‐CoA) reductase inhibitors (statins), atorvastatin, cerivastatin, fluvastatin, pravastatin, lovastatin and simvastatin, reduce atherogenesis and cardiovascular morbidity. Besides, there is growing evidence that statins have immunomodulatory activities. Statins downregulate the expression of adhesion molecules, intercellular adhesion molecule‐1 (ICAM‐1), monocyte chemotactic protein‐1 (MAC‐1) and lymphocyte function‐associated antigen‐1 (LFA‐1), on leucocytes and endothelial cells and, through binding to LFA‐1, interfere with ICAM‐1–LFA‐1 interaction, which is crucial for activation of lymphocytes by antigen‐presenting cells, ingress of leucocytes into the inflammation sites and immunologic cytotoxicity. Statins inhibit the inducible expression of major histocompatibility complex class II in several cell types including macrophages and downregulate the expression of T‐helper‐1 (Th1) chemokine receptors on T cells, leading further to inhibition of activation of lymphocytes and their infiltration into the inflammation sites. Statins block the induction of inducible nitric oxide synthase and the expression of several proinflammatory cytokines such as tumour necrosis factor‐α and interferon‐γ in macrophages and possess antioxidant effects. These agents inhibit the proliferation of immunocytes and the activation of natural killer cells. Regarding the above facts and in view of their safety and inexpensiveness, statins may prove invaluable in the treatment of a multiplicity of dermatologic disorders, especially those characterized by ingress of activated leucocytes into the skin, such as alopecia areata, vitiligo, lichen planus, subacute cutaneous lupus erythematosus, erythema multiforme, psoriasis, bullous pemphigoid, systemic sclerosis, mycosis fungoides, toxic epidermal necrolysis and Behcet's disease.