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Retinoids

»What are retinoids?
»How do vitamin A and retinoids exert their effect at a molecular level?
»Which retinoids are prescribed for the treatment of skin diseases?
»Are there any retinoids found in topical over-the-counter (OTC) products?
»What are the clinical indications for using topical tretinoin?
»What is the mechanism of action of tretinoin in acne vulgaris?
»How should topical tretinoin be used to treat acne vulgaris?
»After starting topical tretinoin for acne vulgaris, the patient reports that her acne is worse. Should she immediately discontinue the drug?
»Is topical tretinoin cream really useful in treating photoinduced wrinkles?
»Is there clinical evidence that topical retinoids improve melasma?
»What are the side effects of topical tretinoin?
»Is topical tretinoin safe to use during pregnancy or when nursing?
»What are the clinical indications for tazarotene?
»What are the clinical indications for alitretinoin?
»Do retinoids have any role in the treatment or prevention of cancer?
»What are the clinical indications for oral isotretinoin?
»What is the mechanism of action of oral isotretinoin in acne vulgaris?
»Are there any contraindications to the use of oral isotretinoin?
»How is oral isotretinoin administered for the treatment of acne vulgaris?
»What are the side effects of oral retinoid therapy?
»Are there any strategies or treatments that reduce the dry skin and lips associated with retinoid therapy?
»Are the clinical indications for acitretin the same as for isotretinoin?
»What is the mechanism of action of acitretin?
»How is acitretin administered for the treatment of psoriasis?
»What are the contraindications for using oral acitretin?

 
 
 

What are retinoids?

Retinoids are structural analogs of vitamin A (retinol). Vitamin A is a fat-soluble vitamin that was first extracted from egg yolk in 1909. It can be obtained directly from the diet (e.g., liver) or produced from carotenoids, a pigmented precursor that is found in abundance in yellow vegetables such as carrots. Beta-carotene, the primary carotenoid found in carrots, is particularly efficient in its ability to be converted to vitamin A. The physiologic effects of vitamin A are broad, but the most important functions include tissue differentiation (especially epithelial tissues), general growth, visual function, and reproduction. Retinoids may be produced naturally during vitamin A metabolism, but most retinoids used in the treatment of skin diseases are synthetic. Synthetic retinoids are produced by changing either the polar end group, polyene side chain, or cyclic group of vitamin A. More than 1500 retinoids have been synthesized and tested for their biologic properties since 1968.