Another Use for Tretinoin—Pseudoacanthosis Nigricans

Abstract

To the Editor.— Tretinoin (vitamin A acid) has been found to be a valuable therapeutic agent in the treatment of various dermatologic conditions. Recent reports document its efficacy in the treatment of acne vulgaris, 1 senile comedones, 2 verrucae planae, 3 keratoderma, 4 plantar warts, 5 psoriasis, 6 naevus comedonicus, 7 Darier disease, 8 and lamellar ichthyosis. 9 We have recently treated an 18-year-old white girl who had pseudoacanthosis nigricans (per Curth's classification 10 ) with tretinoin. The results were dramatic (Fig 1 to 3); 0.1% tretinoin in a cream base applied twice daily was employed with dramatic results. A loss of the dense hyperpigmentation and a marked decrease in the hyperkeratotic verrucous lesions was noted within two weeks. Mild axillary irritation was remedied with 0.01% fluocinolone acetonide cream. This condition has now been well controlled for over six months with weekly application of tretinoin. We would therefore suggest to our colleagues that tretinoin be further evaluated as therapy for acanthosis nigricans.