Abstract
Retinoids have numerous applications in inflammatory, dyskeratotic, and oncohematology diseases. Retinoids have now reached the fourth generation, progressively reducing toxicity whilst increasing their efficacy. Trifarotene is a new fourth-generation retinoid with a selective action on RAR-γ. In this review, we reported the trials—both concluded and in progress—including the use of trifarotene in dermatological diseases. Studies were identified by searching electronic databases (MEDLINE, EMBASE, PubMed, Cochrane, Trials.gov) from 2012 to today and reference lists of respective articles. Only articles published in English language were included. Randomized trials evaluating trifarotene tolerability, safety, and efficacy in congenital ichthyosis and acne have demonstrated great results and mild side effects, leading to the approval by the FDA of trifarotene for the treatment of lamellar ichthyosis in 2014, and of acne vulgaris in October 2019. No high-quality randomized clinical trials have evaluated the treatment of primary cutaneous lymphomas with trifarotene. Finally, we are hypothesizing future perspectives in the treatment of non-melanoma skin cancers, fungal infections, photoaging, and hand-foot skin reactions with trifarotene.
Highlights
IntroductionVitamin A (or retinol, a diterpene), a cardinal micronutrient in human metabolism, is a lipophilic molecule composed by isoprene units
We have focused our attention on trifarotene, a new fourth-generation retinoid with a selective action on retinoic acid receptor (RAR)-γ
Trifarotene has been tested for the treatment of acne and congenital ichthyosis, demonstrating its safety and tolerability
Summary
Vitamin A (or retinol, a diterpene), a cardinal micronutrient in human metabolism, is a lipophilic molecule composed by isoprene units. As an isoprenoid, it is characterized by a hydrocarbon chain containing an ending hydroxyl. The term “retinoid” concerns both natural and synthetic analogues of vitamin A. In synthetic analogues, such as etretinate, acitretin, or tazarotene, a benzene ring substitutes the cyclohexane. According to the International Union of Pure and Applied Chemistry and the International Union of Biochemistry and Molecular Biology, retinoids are characterized by four isoprene units with a head-to-tail structure [1]
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