Brecher Alexandra R, Orlow Seth J
Department of Dermatology, New York University School of Medicine, New York, New York, USA.
J Am Acad Dermatol. 2003 Aug;49(2):171-82; quiz 183-6. doi: 10.1067/s0190-9622(03)01564-0.
The efficacy of systemic retinoid therapy in a number of dermatologic diseases is well established; however, concerns about potential side effects limit their use, especially in children. We review the efficacy and toxicity of oral retinoids in the pediatric population. The acute mucocutaneous toxicities commonly observed are typically well tolerated, readily treatable, and reversible. Systemic toxicities include teratogenicity and effects on the musculoskeletal, neurologic, and gastrointestinal systems. Children, like adults, generally tolerate short-term retinoid therapy without major complications. Concerns regarding serious systemic side effects are greater for those on high doses of oral synthetic retinoids for longer periods of time. Close patient monitoring and patient education can minimize the occurrence of complications. (J Am Acad Dermatol 2003;49:171-82.)Learning objective At the conclusion of this learning activity, participants should be familiar with use of oral retinoids for childhood dermatologic conditions such as psoriasis, acne, and ichthyoses as well as safety and risks associated with oral retinoid use in children and adolescents.
全身性维甲酸疗法在多种皮肤病中的疗效已得到充分证实；然而，对潜在副作用的担忧限制了其应用，尤其是在儿童中。我们综述了口服维甲酸在儿科人群中的疗效和毒性。常见的急性黏膜皮肤毒性通常耐受性良好、易于治疗且可逆转。全身性毒性包括致畸性以及对肌肉骨骼、神经和胃肠道系统的影响。与成人一样，儿童一般能耐受短期维甲酸治疗且无重大并发症。对于长期高剂量口服合成维甲酸的患者，对严重全身性副作用的担忧更大。密切的患者监测和患者教育可将并发症的发生降至最低。（《美国皮肤病学会杂志》2003年；49:171 - 82。）学习目标 在本学习活动结束时，参与者应熟悉口服维甲酸在儿童皮肤病如银屑病、痤疮和鱼鳞病中的应用，以及儿童和青少年使用口服维甲酸相关的安全性和风险。
