Suggested Guidelines for Patient Monitoring: Hepatic and Hematologic Toxicity Attributable to Systemic Dermatologic Drugs

Stephen E. Wolverton, Kathleen Remlinger

Research output: Contribution to journalReview article

20 Scopus citations


Hepatic and hematologic toxicity are among the most fearful adverse effects that occasionally occur as a result of systemic drugs in the dermatologist's therapeutic armamentarium. Drugs of greatest interest concerning hepatic toxicity include methotrexate, azathioprine, dapsone, and acitretin. Somewhat overlapping are drugs that have important hematologic toxicities, including methotrexate, azathioprine, dapsone, sulfonamides, cyclophosphamide, and chlorambucil. Laboratory tests most commonly used include (1) hepatic monitoring: transaminases (AST/SGOT and ALT/SGPT) and the ultrasound-guided liver biopsy, and (2) hematologic monitoring: CBC with diff and platelets along with occasional use of the reticulocyte count. Important principles and specific guidelines for monitoring by drug group are highlighted.

Original languageEnglish (US)
Pages (from-to)195-205
Number of pages11
JournalDermatologic Clinics
Issue number2
StatePublished - Apr 1 2007


ASJC Scopus subject areas

  • Dermatology

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