Berbis P
Clinique dermatologique, Hôtel-Dieu, Marseille.
Rev Prat. 1991 Oct 15;41(22):2180-1.
Aromatic retinoids are synthetic vitamin A derivatives that are particularly active in the treatment of severe psoriasis. They have two pharmacodynamic properties: a regulating effect on epidermal differentiation, and an immunomodulating effect, notably on some functions of granulocytes. Two compounds from this group are now available: etretinate (Tigason) and its active metabolite and future successor acitretin (Soriatane). Retinoids are indicated in pustular psoriasis, erythrodermic psoriasis and extensive psoriasis vulgaris. The mean daily dose in adults is 30 to 50 mg for etretinate and 30 to 35 mg for acitretin. The dose-dependent cutaneous and mucosal side-effects consist of dryness of mucous membranes, desquamation of the extremities and fragility of the skin. Laboratory tests for liver function and lipids must be performed regularly. Because of their teratogenicity, retinoids are strictly contra-indicated in pregnant women and otherwise require and efficient contraception pursued for at least two years after withdrawal of etretinate or acitretin therapy.
芳香维甲酸是合成的维生素A衍生物，在重度银屑病的治疗中具有特别显著的活性。它们具有两种药效学特性：对表皮分化的调节作用和免疫调节作用，尤其是对粒细胞的某些功能。该类别的两种化合物现已上市：依曲替酯（银屑灵）及其活性代谢产物和后续替代药物阿维A（方希）。维甲酸适用于脓疱型银屑病、红皮病型银屑病和广泛的寻常型银屑病。成人依曲替酯的平均日剂量为30至50毫克，阿维A为30至35毫克。剂量依赖性的皮肤和黏膜副作用包括黏膜干燥、四肢脱屑和皮肤脆弱。必须定期进行肝功能和血脂的实验室检查。由于其致畸性，维甲酸在孕妇中严格禁用，否则在停用依曲替酯或阿维A治疗后至少需要进行两年有效的避孕措施。
