VITAMIN A DERIVATIVES USE IN THE TREATMENT OF SKIN CONDITIONS

Abstract

Retinoids are used to treat various skin diseases. They add valuable impact of when used early in the treatment of dermatological conditions. Overall vitamin A derivatives are underused, with isotretinoin is the most used. This paper aims to develop prescribers’ knowledge about their benefits, to improve their usability and aids in alleviating patient concerns to improve therapeutic outcomes in dermatological conditions. In acne vulgaris, adapalene gel and tretinoin cream showed equal efficacy. In psoriasis the combination of acitretin and PUVA was superior to PUVA alone. Acitretin showed a reduction of 41% in the Nail Psoriasis Severity Index and similar efficacy to potent steroids and calcipotriol. In chronic hand eczema, alitretinoin showed 50% improvement in patient’s refractory to steroid treatment. In photoaging and aging, retinoids were shown to increase the synthesis and decrease the degradation rate of collagen and hyaluronate, reducing the impact of aging. In rosacea, topical and systemic isotretinoin showed complete remission in 24% of the patients compared to only 14 % with antibiotics (metronidazole and doxycycline). In lichen planus, isotretinoin demonstrated clinical and histopathological efficacy. In cutaneous T-cell lymphoma, bexarotene used alone or with PUVA or narrow band UVB, showed a response between 80.0% to 84.0%. Lastly in Kaposi sarcoma alitretinoin gel showed superiority to all other agents and better tolerance. This review highlights the benefit of timely use of vitamin A derivatives to encourage wider use.