← All decks
Dermatology
Retinoids
Built from Dermatology, 5th Edition
What’s inside
6 sections · 102 slides
Introduction and mechanism of action
What retinoids are, how they were discovered, and how they act on genes
- What retinoids are
- How retinoids were discovered
- Milestones in retinoid development
- Four generations of synthetic retinoids
- Chemical structures of natural and synthetic retinoids
- Biologic functions of retinoids
- Biologic functions of retinoids.
- Vitamin A absorption and transport
- Metabolism and mechanism of action of natural retinoids
- From retinol to retinoic acid
- Retinoic acid receptors: RAR and RXR
- Binding of natural and synthetic retinoids to nuclear receptors
- How a bound receptor switches on a gene
- Two ways retinoids change gene activity
- Retinoic acid and the immune system
- Retinoids replenish vitamin A lost from sun exposure
- Physiologic concentrations of retinoids in skin and blood
The individual retinoid drugs
Pharmacology of each generation, from natural tretinoin to selective fourth-generation agents
- Pharmacokinetics: features all retinoids share
- Key pharmacologic features of retinoids: absorption and half-life.
- Key pharmacologic features of retinoids: absorption and half-life. (continued)
- Key pharmacologic features of retinoids: metabolism and excretion.
- Key pharmacologic features of retinoids: metabolism and excretion. (continued)
- Nuclear receptor binding profile of retinoids.
- Nuclear receptor binding profile of retinoids. (continued)
- Tretinoin (all-trans-retinoic acid)
- Isotretinoin (13-cis-retinoic acid)
- Why only isotretinoin shrinks oil glands
- Alitretinoin (9-cis-retinoic acid)
- Acitretin
- Acitretin, alcohol, and contraception timing
- 3 yr
- Adapalene
- Tazarotene
- Bexarotene
- Trifarotene
- Retinoic acid metabolism blocking agents (RAMBAs)
- RAMBA trial result in lamellar ichthyosis
Clinical indications
Which retinoid, topical or oral, treats which skin disease
- Topical vs. systemic retinoids: the big picture
- Clinical indications for retinoids in dermatology.
- Clinical indications for retinoids in dermatology. (continued)
- Clinical indications for retinoids in dermatology. (continued)
- Clinical indications for retinoids in dermatology. (continued)
- Starting a patient on a topical retinoid
- Topical retinoids for acne
- Topical retinoids for psoriasis and photoaging
- Chronic plaque-type psoriasis before and after acitretin plus PUVA
- Systemic retinoids for psoriasis
- Combining acitretin with light therapy
- Systemic retinoids for acne
- Severe acne vulgaris before and after oral isotretinoin
- Isotretinoin dosing: the cumulative-dose idea
- Isotretinoin course: timing and relapse
- Severe acne vulgaris before and after oral isotretinoin, second example
- Isotretinoin: the pregnancy-prevention rule
- Retinoids for cutaneous T cell lymphoma (CTCL)
- Approach to initiating oral bexarotene therapy for cutaneous T cell lymphoma.
- Approach to initiating oral bexarotene therapy for cutaneous T cell lymphoma. (continued)
- Chronic hand eczema: oral alitretinoin
- Retinoids for disorders of cornification
- Lamellar ichthyosis before and after acitretin
- Retinoids for Darier disease and pityriasis rubra pilaris
- Pityriasis rubra pilaris before and after acitretin
- Retinoids for rosacea, precancers, and lupus
Dosage and formulations
What strengths and routes each retinoid comes in, and why the route matters
- Choosing a formulation and route
- Formulations of topical and systemic retinoids.
- Formulations of topical and systemic retinoids. (continued)
Contraindications and adverse effects
Who should not take a retinoid, and what to watch for during treatment
- Contraindications to retinoid therapy
- Topical retinoid side effects
- Adverse effects of topical retinoids.
- Retinoid dermatitis on the face during oral isotretinoin
- Teratogenicity: the central risk of systemic retinoids
- Retinoid embryopathy.
- Retinoid embryopathy. (continued)
- Preventing pregnancy during isotretinoin therapy
- Skin and mucous membrane effects of oral retinoids
- Cheilitis during isotretinoin therapy
- More mucocutaneous effects
- Dyslipidemia: raised triglycerides and cholesterol
- Managing bexarotene-induced hyperlipidemia
- Liver effects of retinoid therapy
- Eye and vision effects
- Bone and joint effects
- Spinal osteophytes in a patient on prolonged isotretinoin
- Muscle, nervous system, and mood effects
- Thyroid, blood, and gut effects
- Adverse effects of systemic retinoids.
- Adverse effects of systemic retinoids. (continued)
- Drug interactions to avoid or watch
- Retinoids in pregnancy and breastfeeding
Summary
The essential facts about retinoids in dermatology, in one place
- Key points to remember
- Most adverse effects are manageable
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)