Retinoid therapy for acne - A comparative review
Retinoid therapy for acne - A comparative review
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DOI：
10.2165/00128071-200506010-00002
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发表时间：
2005-01-01
影响因子：
7.3
通讯作者：
Chivot, M
中科院分区：
文献类型：
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作者：
Chivot, M
维甲酸在痤疮治疗中起着至关重要的作用，因为它们作用于原发性皮损——微粉刺。它们是维生素A（视黄醇）的合成衍生物，因其有效性而被选用。有几种化合物可用于治疗痤疮，有外用的也有全身性用药的形式。我们描述并比较了不同的外用维甲酸类药物，如维甲酸（全反式维甲酸）、异维甲酸（13 - 顺式维甲酸）、阿达帕林（源自萘甲酸）和他扎罗汀（乙炔维甲酸）。它们主要起粉刺溶解作用，但最近也发现了抗炎作用。维甲酸有很大的益处，但也有一些不良反应，主要的是致畸性。对于孕妇，最好不要使用外用形式的维甲酸，尽管只有他扎罗汀必须进行妊娠试验。只有异维甲酸采用全身性用药形式。它对痤疮的所有致病因素都有作用，能使病情长期缓解，有时甚至能完全治愈。由于其致畸性，对于育龄妇女必须采取预防措施。了解其其他不良反应也很重要，要向患者解释清楚，如果可能的话，提前进行处理。
Retinoids play a vital role in the treatment of acne because they act on the primary lesion, the rnicrocomedo. They are synthetic derivatives of vitamin A (retinol), and are selected for their effectiveness. Several compounds are used for acne, either in topical or systemic form.We describe and compare the different topical retinoids, tretinoin (all-trans-retinoic acid), isotretinoin (13-cis-retinoic acid), adapalene (derived from naphthoic acid), and tazarotene (acetylenic retinoid). They act mainly as comedolytics, but anti-inflammatory actions have also been discovered recently. The retinoids have great beneficial effects, but also some adverse effects, the main one being teratogenicity. It is preferable not to use them in topical form for pregnant women, although a pregnancy test is only compulsory for tazarotene.Only isotretinoin is used in systemic form. It acts on all the factors of acne and offers long remissions, and sometimes complete cures. Precautions must be taken for women of childbearing age due to its teratogenicity. It is also important to be aware of its other adverse effects, explain them to the patient and, if possible, deal with them in advance.