Silverman A K, Ellis C N, Voorhees J J
J Am Acad Dermatol. 1987 May;16(5 Pt 1):1027-39. doi: 10.1016/s0190-9622(87)70133-9.
Retinoids have and will continue to revolutionize dermatologic therapy in a manner analogous to the development of topical corticosteroids. Isotretinoin, for example, has made nodulocystic scarring acne an eminently treatable condition. The dermatologic armamentarium now includes a powerful new agent, etretinate, which will radically change the approach to psoriasis (and other keratinizing disorders). Although each new retinoid is developed with the aim of maximizing specific therapeutic effects and minimizing toxicity, the fact remains that the major side effects of retinoid treatment are those of hypervitaminosis A syndrome. Optimal clinical utilization of new retinoids is best accomplished by an assessment of what is currently known about retinol absorption, metabolism and organ-specific effects, as well as by a thorough understanding of hypervitaminosis A syndrome. In this paper, hypervitaminosis A syndrome is reviewed as a paradigm of retinoid side effects.
维甲酸类药物已经并将继续以类似于局部用皮质类固醇药物发展的方式彻底改变皮肤病治疗方法。例如，异维甲酸已使结节囊肿性瘢痕性痤疮成为一种完全可治疗的疾病。皮肤病治疗手段现在包括一种强大的新药——阿维A酯，它将从根本上改变治疗银屑病（以及其他角化性疾病）的方法。尽管每一种新的维甲酸类药物的研发目的都是使特定治疗效果最大化并使毒性最小化，但事实仍然是，维甲酸类药物治疗的主要副作用是维生素A过多综合征的副作用。对新的维甲酸类药物进行最佳临床应用，最好通过评估目前已知的视黄醇吸收、代谢和器官特异性作用，以及透彻了解维生素A过多综合征来实现。在本文中，维生素A过多综合征作为维甲酸类药物副作用的一个范例进行了综述。
