Orfanos C E, Bauer R
Br J Dermatol. 1983 Jul;109 Suppl 25:55-60.
Oral retinoids obviously influence dermal components such as cutaneous capillaries and dermal inflammatory cells in addition to their well-known action on keratinizing epithelia. On this basis, they act as an anti-inflammatory drug. In particular, they reduce the elevated skin temperature, inhibit the motility of neutrophils and eosinophils and their migration into the epidermis, decrease DNA synthesis of human lymphocytes by blocking their response to lectins and stimulate Langerhans cells, monocytes and macrophages in various in vitro and in vivo models. These data indicate that oral retinoids may not only normalize disorders of keratinization but also exert distinct therapeutic effects on various skin diseases with dermal inflammatory involvement regardless of their particular aetiology. In some respects, retinoids resemble corticosteroids, acting as a modified hormone. Preliminary clinical experiences with oral retinoid treatment in skin diseases such as cutaneous disseminated LE, bullous pemphigoid, Duhring's disease, pemphigus, Behçet's disease and necrotizing vasculitis with eosinophilia support these data. Monotherapy or combined administration of oral retinoids with corticosteroids in low doses seems therapeutically beneficial in these disorders.
口服维甲酸除了对角化上皮有众所周知的作用外，显然还会影响皮肤成分，如皮肤毛细血管和真皮炎症细胞。基于此，它们可作为一种抗炎药物。特别是，它们能降低升高的皮肤温度，抑制中性粒细胞和嗜酸性粒细胞的活力及其向表皮的迁移，通过阻断人淋巴细胞对凝集素的反应来减少其DNA合成，并在各种体外和体内模型中刺激朗格汉斯细胞、单核细胞和巨噬细胞。这些数据表明，口服维甲酸不仅可以使角化异常正常化，而且无论其具体病因如何，对各种伴有真皮炎症的皮肤病都能发挥独特的治疗作用。在某些方面，维甲酸类似于皮质类固醇，起到一种修饰激素的作用。在皮肤疾病如皮肤播散性红斑狼疮、大疱性类天疱疮杜林病、天疱疮、白塞病和嗜酸性粒细胞增多性坏死性血管炎中，口服维甲酸治疗的初步临床经验支持了这些数据。在这些疾病中，口服维甲酸单药治疗或与低剂量皮质类固醇联合给药似乎在治疗上是有益处的。
