Cunningham W J, Geiger J M
Roche International Clinical Research Center, Strasbourg, France.
Semin Dermatol. 1992 Dec;11(4):291-301.
In two decades, retinoids have nearly revolutionized some aspects of dermatologic practice. The dramatic response of severe acne to isotretinoin therapy is equally matched at times by the rapid response of pustular psoriasis treated with etretinate. Many other psoriatic patients, especially those who have failed the standard therapeutic regimens, have immensely benefited by the addition of retinoids to the therapeutic armamentaria. The use of etretinate or acitretin where available has repeatedly shown their utility, general safety, and cost effectiveness. Additionally, the advent of combination therapy with UV light has allowed better response using less retinoid and less light, eg, in retinoid-light combinations. With careful attention to the safety profile of retinoids, especially in the area of pregnancy prevention, a powerful therapy option is available for even the most recalcitrant patients. These responses would be sufficient reason for interest in retinoids but, when coupled with the exciting developments in molecular biology of retinoids, lead one to look with excitement on the dermatologic horizon for a new generation of significant breakthroughs.
在二十年的时间里，维甲酸几乎彻底改变了皮肤科临床实践的某些方面。重度痤疮对异维甲酸治疗的显著反应，有时与脓疱型银屑病用依曲替酯治疗的快速反应相当。许多其他银屑病患者，尤其是那些对标准治疗方案无效的患者，通过在治疗手段中加入维甲酸而受益匪浅。在可获得依曲替酯或阿维A的情况下使用它们，已反复证明了其效用、总体安全性和成本效益。此外，紫外线联合治疗的出现使得在使用较少维甲酸和较少光照的情况下能有更好的反应，例如在维甲酸 - 光联合治疗中。通过密切关注维甲酸的安全性，尤其是在预防妊娠方面，即使是最难治的患者也能获得一种强有力的治疗选择。这些反应足以引起人们对维甲酸的兴趣，但当与维甲酸分子生物学的令人兴奋的进展相结合时，会使人们兴奋地展望皮肤科领域新一代的重大突破。
