← All decks

Dermatology

Retinoids

Built from Dermatology, 5th Edition

The first 25 slides of Retinoids
The first 25 slides, exactly as they appear. The full deck has 102 content slides.

What’s inside

6 sections · 102 slides

  1. 01

    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

    17 slides

  2. 02

    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

    20 slides

  3. 03

    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

    26 slides

  4. 04

    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)

    3 slides

  5. 05

    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

    23 slides

  6. 06

    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)

    13 slides