Modern possibilities of using systemic retinoids in dermatological practice (review of international literature)

Matushevskaya, E. V.; Svirshchevskaya, E. V.

doi:10.17116/klinderma20181705118

Klin. dermatol. venerol.

2018

DOI: 10.17116/klinderma20181705118

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Modern possibilities of using systemic retinoids in dermatological practice (review of international literature)

E. V. Matushevskaya¹,

E. V. Svirshchevskaya²

Abstract: 1 ФГБОУ ДПО «Институт повышения квалификации Федерального медико-биологического агентства России», Москва, Россия; 2 ФГБУН «Институт биоорганической химии им. М.М. Шемякина и Ю.В. Овчинникова РАН», Москва, Россия РЕЗЮМЕ В обзоре представлены данные зарубежных клинических исследований по изучению эффективности и безопасности применения системного изотретиноина (СИ) для лечения ряда дерматологических заболеваний. Рассмотрены механизмы действия ретинола и его производных, эффекты синтетических аналогов ретинола п… Show more

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Cited by 4 publications

References 45 publications

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Methods of rosacea treatment to achieve stable remission in a megalopolis

Vilochkina,

Lindover,

Galukhina

et al. 2024

Medicinskij sovet

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The review article is devoted to the aspects of rosacea therapy in a megalopolis, where a dermatological service is widely developed and it is possible to provide modern diagnostic, therapeutic and preventive measures. Rosacea negatively affects the emotional state of patients, and low awareness of chronic dermatoses often leads to self-medication and skin deterioration. The pathogenetic mechanisms of the disease have not been fully studied. Both genetic predisposition and environmental factors contribute to the occurrence of rosacea. A number of studies confirm that the triggers can be ultraviolet radiation, stress, intense physical activity, temperature changes, dietary characteristics, imbalance of the intestinal microbiota, alcohol consumption. Every day, residents of megalopolises face a combination of these factors, which combined with genetically determined features of the epidermal barrier and immune function, makes them more susceptible to rosacea and other skin diseases. The multifactorial nature of rosacea causes a variety of treatment methods that must be individualized in accordance with the clinical picture of the disease. With mild to moderate rosacea, monotherapy with external drugs is effective – azelaic acid, brimonidine tartrate, ivermectin, metronidazole. For the treatment of severe forms of rosacea, it is advisable to prescribe systemic therapy from groups of retinoids and antibiotics. The results of numerous studies are presented that physiotherapy methods which are available in large cities increase the effectiveness of treatment by reducing erythema and telangiectasia, enhancing repair and microcirculation in the epidermis. The accumulated experience of Russian dermatologists and foreign colleagues allows to determine the most effective combinations of treatment methods to achieve stable remission in patients.

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Methods of rosacea treatment to achieve stable remission in a megalopolis

Vilochkina,

Lindover,

Galukhina

et al. 2024

Medicinskij sovet

View full text Add to dashboard Cite

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Main effects of retinol palmitate on skin structures and the technology of its use in dermatological practice

Petrova

Albanova

Nozdrin³

et al. 2023

Vestnik dermatologii i venerologii

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Vitamin A and its synthetic analogues are used in the treatment of numerous skin diseases. The main genomic effects of the natural form of vitamin A (retinol palmitate) are associated with its active metabolite all-trans-retinoic acid and are compensated by several restrictive mechanisms. Numerous studies have proved that retinol stimulates the proliferation of keratinocytes of the basal layer of the epidermis and endothelial cells, and also activates dermal fibroblasts to synthesize proteins of the extracellular matrix of the dermis. As a result, the thickening the epidermis, increases the mechanical strength of the skin and the hydrating ability of the dermis, angiogenesis increase. The ability of retinol to enhance the adhesion of endothelial cells and leukocytes, regulate the processes of keratinization and sebum secretion was found. Vitamin A is also a powerful antioxidant. Retinol palmitate is used as the main or auxiliary drug for the treatment of a wide range of dermatoses. The principle of application is based on clinical studies and confirmed by existing experimental data. In the treatment, the following algorithm is followed. If retinol palmitate is necessary to improve epithelialization and strengthen the epidermal barrier, medium therapeutic doses should be used. For the treatment of disorders of keratinization processes, depending on the severity of the pathological condition, medium and high therapeutic doses of the drug are used. Violation of the processes of sebum secretion and severe hyperkeratosis respond better to treatment at high therapeutic doses. It should be noted that many skins clinical manifestations mostly regress under the action of vitamin A in doses that do not lead to the appearance of signs of toxicity of the drug.

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The possibilities of using retinol palmitate in the systemic treatment of generalized hereditary keratinization disorders

Petrova

Albanova

2023

Vestnik dermatologii i venerologii

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Hereditary ichthyosis is a group of generalized hereditary keratinization disorders characterized by general dryness of the skin, peeling, hyperkeratosis and often erythroderma. These manifestations are caused by mutations in genes mainly involved in the formation of the skin barrier. Hereditary ichthyosis is divided into syndromic and non-syndromic. Nonsyndromic ichthyoses include: vulgar ichthyosis, recessive X-linked ichthyosis, autosomal recessive congenital ichthyosis, keratinopathic ichthyosis and other forms. At present, the best result for achieving clinical remission has been established with oral retinoids: retinol palmitate, isotretinoin (1st generation of retinoids) and acitretin (2nd generation of retinoids). The ability of retinol palmitate to regulate keratinization processes, strengthen the epidermal barrier and have an antioxidant effect is used in the treatment of generalized hereditary keratinization disorders. Medium and high therapeutic doses (2 000-10 000 IU / kg / day) are used in the treatment. The prescribed dose of retinol palmitate differs in various nosological forms of ichthyosis, and depends on the severity of the pathological process, the age and weight of the patient, which must be taken into account when prescribing therapy to obtain the best result. It should be noted that clinical manifestations mainly regress at doses that do not lead to the appearance of signs of toxicity of the drug. The methods of retinol palmitate treatment of ichthyosis and ichthyosiform erythroderma are described.

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Modern possibilities of using systemic retinoids in dermatological practice (review of international literature)

Cited by 4 publications

References 45 publications

Methods of rosacea treatment to achieve stable remission in a megalopolis

Methods of rosacea treatment to achieve stable remission in a megalopolis

Main effects of retinol palmitate on skin structures and the technology of its use in dermatological practice

The possibilities of using retinol palmitate in the systemic treatment of generalized hereditary keratinization disorders

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