Efficacy of topical isotretinoin 0.05% gel in acne vulgaris: Results of a multicenter, double-blind investigation

Regulation of CD8+ T Lymphocyte Effector Function and Macrophage Inflammatory Cytokine Production by Retinoic Acid Receptor γ

“…ATRA and its derivatives are widely used in clinical treatment of acne (12,13), partly due to its inhibition of inflammatory cytokine production. Moreover, RAR␥ is expressed in macrophages (29,30), suggesting that ATRA may mediate its effect through RAR␥.…”

“…ATRA also inhibits apoptosis in T cell hybridomas (9, 10) and blocks negative selection when added to fetal thymus organ culture (11). Importantly, ATRA and its derivatives inhibit inflammation and are widely used in clinical treatment of acne (12,13). The pleiotropic effects of retinoids are most likely mediated by the tempospatial expression of different retinoid receptors.…”

Clinical Aspects of Topical Retinoids

“…Clinical trials with topical isotretinoin gel suggest roughly comparable efficacy to pub lished data for topical tretinoin in acne [19]. In experimental models, isotretinoin appears to be less comedolytic [22], but it is also less irritating when tested in the same vehicle.…”

“…It is now well accepted that this side effect is indepen dent of its therapeutic efficacy as the 'lower potency' creams and gels achieve similar re sults with less irritation [8,18]. In fact, topical isotretinoin has demonstrated its efficacy in treating acne despite an infrequent incidence of irritation [19], In addition to preventing microcomedo formation and thereby interrupting the patho genic cascade leading to the more inflamma tory lesions of acne, tretinoin also has another important function. Through its capacity to thin the stratum corneum, tretinoin enhances the penetration and efficacy of topical antimi crobial agents [20,21], In this way, combina tion therapy also acts at the inflammatory stage by altering the anaerobic milieu of the follicle and suppressing bacterial prolifera tion.…”

Plasma Concentrations after Three Different Doses of Topical Isotretinoin

“…Unfortunately, the oral use of this com pound often produces extensive side effects, especially congenital malformations [7,8] The optimization of the topical applica tion of isotretinoin was sought in both in vitro and in vivo animal studies with isotretinoin 0.05% gels in local cutaneous applications. This led to results similar to those of oral treatment [9,10]. Herein the systemic entry of topical isotretinoin gel at three different doses was studied in animals.…”