Oldies But Goodies: Systemic, When and If to Use

While dermatology continues to evolve with cutting-edge therapies, Kristien Kucera, PA-C reminded us that the “oldies but goodies”—methotrexate (MTX), cyclosporine, and acitretin—still hold an essential place in clinical practice. She delivered a thorough, practical review of each medication’s mechanism of action, efficacy, contraindications, adverse effects, and monitoring protocols. For MTX, she detailed its historical background, dosing strategies, use of test doses, folic acid supplementation, baseline and ongoing lab work, and critical drug interactions that increase toxicity risk. Cyclosporine was reviewed with equal depth, including its transition from transplant medicine to dermatology. Acitretin’s use was discussed with attention to dosing nuances, teratogenic risks, and long-term safety. This session offered a high-yield refresher on integrating these time-tested agents into modern dermatologic care.