Bosentan in Dermatology: Clinical Applications and Safety

Bosentan, a dual-endothelin (ET) receptor antagonist, has emerged as a valuable therapeutic option in dermatology, despite its primary approval for pulmonary arterial hypertension. Bosentan has diverse applications in dermatological conditions, particularly its role in managing digital ulcers (DUs), non-DUs, Raynaud’s phenomenon (RP), and skin fibrosis in scleroderma patients are quite useful. The drug has shown promising results in preventing and treating DUs, with variable efficacy in RP and skin fibrosis. Limited evidence suggests potential benefits of bosentan in dermatomyositis-associated ulcers and port wine stains. The review also discusses bosentan’s pharmacokinetics, dosing regimens, safety profile, and monitoring requirements, highlighting the importance of regular hepatic function surveillance.