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Adnexal Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Hasan Aksoy, Jordan V. Wang, Ayşe Serap Karadağ
Topical retinoids regulate follicular keratinization, which can reduce microcomedo formation and offer comedolytic activity. They are also anti-inflammatory and can reduce pigmentation and scar formation. Topical retinoids include tretinoin, isotretinoin, tazarotene, adapalene, and trifarotene.
Psoriasis and lichen planus
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
Retinoids are analogues of retinol (vitamin A). They exert important actions on cell division and maturation, and acitretin is of particular value in psoriasis. The drug benefits patients with all types of severe psoriasis after 3–4 weeks of administration but is most effective when used in combination with some form of ultraviolet treatment. Its major drawback is that it is markedly teratogenic and can only be given to fertile women if they use contraception and are prepared to continue using efficient and reliable contraceptive measures for 3 years after stopping treatment. Other significant toxicities include hyperlipidaemia and a possibility of hyperostosis and extraosseous calcification. In addition, it does have some hepatotoxicity in a few patients. These ‘significant’ toxicities are not common; but minor mucosal side effects occur in all patients, including drying of the lips and the buccal, nasal, and conjunctival mucosae. Minor generalized pruritus and slight hair loss also occur. Oral retinoids should only be prescribed by dermatologists, i.e. those who are familiar with their actions and effects.
Other Systemic Side Effects: Cardiovascular, Pulmonary, Otolaryngorhinologic, Genitourinary, Renal, and Immunologic
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Emin Ozlu, Akif Bilgen, Ayse Serap Karadag
Retinoids are a group of compounds derived from natural vitamin A and synthetic analogs. Retinoids can be categorized into three groups based on their molecular structures: first, second, and third generation. Currently, retinoids are used in several fields of dermatology. Although retinoids are very effective agents, unwanted side effects can occur whether used topically or systemically.
Emerging drugs for the treatment of acne: a review of phase 2 & 3 trials
Published in Expert Opinion on Emerging Drugs, 2022
Siddharth Bhatt, Rohit Kothari, Durga Madhab Tripathy, Sunmeet Sandhu, Mahsa Babaei, Mohamad Goldust
Retinoids are Vitamin A analogues. These molecules bind to the Retinoic acid receptor (RAR) and Retinoid X receptor (RXR), heterodimerize or homodimerize and then translocate to the nucleus where they bind to the Retinoic acid response element (RARE) bringing about their biological effects. In the skin, retinoids modulate the proliferation and differentiation of the keratinocytes and regulate the activity of the adhesion molecules also. It also down-regulates the expression of TLR 2 receptor which reduces Cutibacterium acnes mediated inflammation. Reduction in the size of sebaceous glands and sebum production is of particular importance in the treatment of acne. Currently, FDA approves the use of Isotretinoin for acne vulgaris. The most dreaded side effect which limits the use of retinoids is teratogenicity. Furthermore, as acne is commoner in adolescents and young adults, the risk of teratogenicity always needs to be weighed while prescribing it. Side effects include dose dependent muco-cutaneous problems like are dryness of mouth, lipid abnormalities which may rarely lead to pancreatitis, hepatitis. Pseudotumor cerebri neuropsychiatric manifestations like depression, sexual dysfunction have also remain a significant concern though these side effects are uncommon [2,5].
Alitretinoin for the treatment of severe chronic eczema of the hands
Published in Expert Opinion on Pharmacotherapy, 2022
Maddalena Napolitano, Luca Potestio, Mario De Lucia, Mariateresa Nocerino, Gabriella Fabbrocini, Cataldo Patruno
The first-line therapeutic strategies for the management of CHE include skin education program and lifestyle changes [6], such as the avoidance of patch test proven contact allergens or irritants. The frequent application of emollients strongly helps the restoration of skin and is considered as the cornerstone treatment [6]. Topical corticosteroids or calcineurin inhibitors are prescribed as anti-inflammatory drugs. However, up to 65% of patients require systemic options [13]. Alitretinoin is the first systemic therapy in patients with severe CHE refractory also to potent topical corticosteroids approved in the European Union (EU) [14]. It is an endogenous retinoid, structurally related to vitamin A [15]. Retinoids are a family of natural and synthetic compounds which are used for different skin disorders [15].
All-trans retinoic acid in anticancer therapy: how nanotechnology can enhance its efficacy and resolve its drawbacks
Published in Expert Opinion on Drug Delivery, 2021
Gabriel Silva Marques Borges, Flávia Alves Lima, Guilherme Carneiro, Gisele Assis Castro Goulart, Lucas Antônio Miranda Ferreira
Retinoids are synthetic or natural derivatives of vitamin A, including retinol, retinal, 13-cis retinoic acid (isotretinoin), and adapalene. All-trans retinoic acid (ATRA, tretinoin) is the physiological active form of vitamin A and is one of the most studied retinoids during the last 50 years. ATRA started to be used in 1971 as an anti-acne drug, showing a strong activity against skin disorders [1]. Beyond its dermatological use, in 1980, it was discovered that ATRA has important differentiation properties in hematological cells. This differentiation activity dramatically changed the course of acute promyelocytic leukemia (APL) [2]. The use of ATRA as an oral differentiation agent in APL patients was, back then, a unique case in antineoplastic therapy and turned APL from one of the most aggressive types of leukemia to one of the most successfully treatable [3].