alitretinoin and Acne-Vulgaris

9-cis-Retinoic acid (9-cis-RA) is as active as 13-cis-retinoic acid (13-cis-RA) in inhibiting the proliferation of cultured human sebocytes and in reducing the size of sebaceous glands of hamsters.. Evaluate the anti-acne effect of 9-cis-RA compared to that of 13-cis-RA in a pilot study.. Four young male patients with acne were treated in an open study consecutively with 9-cis-RA and 13-cis-RA given at similar doses.. No beneficial effects were observed with 9-cis-RA in any of the patients whereas all responded favorably to 13-cis-RA.. For the two retinoids tested, the anti-acne effect correlates with the sebosuppressive effect in humans.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Alitretinoin; Animals; Cells, Cultured; Cricetinae; Disease Models, Animal; Humans; Isotretinoin; Keratolytic Agents; Male; Pilot Projects; Retinoids; Sebaceous Glands; Sebum; Treatment Outcome; Tretinoin

It is generally accepted that the inhibition of sebum excretion has a predictive value for anti-acne activity. Whereas oral 13-cisretinoic acid (13-cis-RA) decreases sebum excretion, it has not been shown so far if oral all-trans-retinoic acid (tretinoin, tRA) does so. The aim of this exploratory study was to investigate the effect of oral tRA on the sebum excretion rate (SER) in young male subjects.. 12 healthy volunteers with a baseline SER above 1.0 microgram/cm2/min were treated with 20 mg/day tRA for 4 weeks. The SER was measured at weeks 2 and 4. Adverse reactions were recorded.. The mean SER varied from 1.56 at baseline to 1.65 at week 2 and to 1.49 micrograms/cm2/min at week 4. Comparison with values obtained in the same subjects previously treated with either 13-cis-RA or 9-cis-retinoic acid indicated that tRA less sebosuppressive. Mucocutaneous reactions and headache were the most frequent side effects of oral tRA.. The lack of effect on the SER suggests that oral tRA would probably be ineffective against acne. The fact that, of the three isomers tested, only 13-cis-RA (which does not bind to nuclear receptors) shows activity may suggest that sebosuppression is not nuclear receptor mediated. We discuss other hypotheses related to pharmacokinetics.

Topics: Acne Vulgaris; Administration, Oral; Adult; Alitretinoin; Drug Eruptions; Facial Dermatoses; Headache; Humans; Isotretinoin; Keratolytic Agents; Lip Diseases; Male; Mucous Membrane; Retinoids; Sebum; Skin; Tretinoin

The link between isotretinoin, treatment of a severe form of acne, and psychiatric disorders remains controversial, as acne itself could explain the occurrence of psychiatric disorders. This study aims at assessing the disproportionality of psychiatric adverse events reported with isotretinoin in the French National PharmacoVigilance Database, compared with other systemic acne treatments and systemic retinoids.. Data were extracted from the French National PharmacoVigilance Database for systemic acne treatments, systemic retinoids and drugs used as comparators. Each report was subjected to double-blind analysis by two psychiatric experts. A disproportionality analysis was performed, calculating the number of psychiatric ADRs divided by the total number of notifications for each drug of interest.. Concerning acne systemic treatments: all 71 reports of severe psychiatric disorders involved isotretinoin, the highest proportion of mild/moderate psychiatric adverse events was reported with isotretinoin (14.1%). Among systemic retinoids, the highest proportion of severe and mild/moderate psychiatric events occurred with isotretinoin and alitretinoin.. Our study raises the hypothesis that psychiatric disorders associated with isotretinoin are related to a class effect of retinoids, as a signal emerges for alitretinoin. Complementary studies are necessary to estimate the risk and further determine at-risk populations.

Topics: Acne Vulgaris; Adverse Drug Reaction Reporting Systems; Alitretinoin; Databases, Factual; Dermatologic Agents; Female; France; Humans; Isotretinoin; Male; Mental Disorders; Pharmacovigilance; Retinoids; Risk; Severity of Illness Index; Tretinoin; Young Adult

Topics: Acne Vulgaris; Adult; Alitretinoin; Clinical Protocols; Dermatologic Agents; Female; Food Hypersensitivity; Glycine max; Humans; Isotretinoin; Nut Hypersensitivity; Tretinoin