Ferguson J, Johnson B E
Br J Dermatol. 1986 Sep;115(3):275-83. doi: 10.1111/j.1365-2133.1986.tb05742.x.
Six subjects taking isotretinoin were studied, none of whom had clinical or phototest evidence of photosensitivity. Of nine subjects taking etretinate, one had convincing clinical photosensitivity consisting of a burning erythema on sunlight exposure. His phototesting results showed a marked abnormality from 300 +/- 5 nm to 365 +/- 30 nm which returned close to normal limits within one month of stopping therapy. Although clinically normal, another subject taking etretinate had similar phototest evidence of abnormal photosensitivity. In vitro photohaemolysis studies demonstrated that tretinoin (all-trans-retinoic acid) and isotretinoin have a potential, while etretinate has none. However, the major metabolite of etretinate (Ro 10-1670) had a phototoxic potential greater than that of tretinoin. The apparently low incidence of photosensitivity suggests that an idiosyncrasy is responsible, perhaps due to a disorder of pharmacokinetics or metabolism. Clinical cases should use appropriate photoprotection against UVB and UVA wavebands.
对6名服用异维A酸的受试者进行了研究，他们均无临床或光试验光敏证据。在9名服用阿维A酯的受试者中，1人有令人信服的临床光敏表现，即日光暴露后出现灼热性红斑。他的光试验结果显示，在300±5纳米至365±30纳米范围内有明显异常，在停止治疗1个月内恢复至接近正常范围。另一名服用阿维A酯的受试者虽然临床正常，但有类似的光试验异常光敏证据。体外光溶血研究表明，维甲酸（全反式维甲酸）和异维A酸有潜在光敏性，而阿维A酯没有。然而，阿维A酯的主要代谢产物（Ro 10-1670）的光毒性潜力大于维甲酸。光敏发生率明显较低，提示可能存在特异反应，或许是由于药代动力学或代谢紊乱所致。临床病例应针对UVB和UVA波段采取适当的光防护措施。
