Topical Retinoic Acid Does Not Alter the Vasoconstrictive Properties of Topical Corticosteroids in Humans

Schmied, C; Saurat, Jean‐Hilaire

doi:10.1159/000247755

Cited by 5 publications

(7 citation statements)

References 12 publications

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“…This is concordant with our pre vious observation [8] that this association has the same vasoconstrictive activity as the steroid alone.…”

Section: Discussionsupporting

confidence: 92%

“…That RA may be used to prevent topical steroid-induced atrophy in human requires different steps of analysis. We have previously shown [8] that pretreatment of normal skin with topical RA 0.05, 0.025 and 0.01% did not inhibit corticosteroid-induced vasoconstriction; this suggested that RA may not interfere with the anti-inflammatory property of the ste roid. It was also found that the vasoconstrictive activity of triamcinolone acetonide (TA) 0.1% was preserved when 0.025% RA was added in the same preparation, indicating that the mixture may have anti-inflammatory activity.…”

Section: Introductionmentioning

confidence: 95%

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Treatment of Eczema with a Mixture of Triamcinolone Acetonide and Retinoic Acid A Double-Blind Study

Schmied

Piletta²,

Saurat³

1993

Dermatology

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Dermo-epidermal atrophy is one of the main side effects of long-term treatment with topical corticosteroids (TC). Retinoic acid (RA) may prevent and even reverse these effects in animals. It has been previously established that topical RA (TRA) does not inhibit corticosteroid-induced vasoconstriction in humans, thus suggesting that RA, combined with TC, does not interfere with its anti-inflammatory property. The next step was to test this association in patients with inflammatory skin disorders. In this symmetrical double-blind study, triamcinolone acetonide (TA) cream 0.1% and a cream containing TA 0.1% plus RA 0.025% (TARA) were compared in 18 subjects with eczema. No statistical difference between both treatments was observed after 1 2 and 3 weeks, although on the TARA-treated sides the anti-inflammatory responses were slightly less pronounced. Subjective irritation was significantly more frequent in TARA-treated side (3/17, p = 0.05) but did not lead to interruption of the treatment. This indicates that addition of RA 0.025% to a medium-range potency topical steroid does not abrogate the anti-inflammatory property of the latter and that the association can be tolerated by inflamed skin.

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“…This is concordant with our pre vious observation [8] that this association has the same vasoconstrictive activity as the steroid alone.…”

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 95%

Treatment of Eczema with a Mixture of Triamcinolone Acetonide and Retinoic Acid A Double-Blind Study

Schmied

Piletta²,

Saurat³

1993

Dermatology

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“…Repeated daily application during 4 consecutive d of the different compounds did not induce noticeable erythema, scaling or infiltration at the site of application except for the typical halo of vasoconstriction when corticosteroids were applied, both pure or in association with retinoie acid, as previously 1-eported (13).…”

Section: Resultsmentioning

confidence: 72%

“…These have been explored for therapeutic use as well as to countetact the side effects of each other (11)(12)(13)(14); little data is currently available on the tnolecuiar mechanism of this interaction in human skin in vivo. These have been explored for therapeutic use as well as to countetact the side effects of each other (11)(12)(13)(14); little data is currently available on the tnolecuiar mechanism of this interaction in human skin in vivo.…”

Section: Discussionmentioning

confidence: 99%

“…Topical giucocorticoids are reported to decrease the acute toxicity of topical retinoic acid in human skin (11). Topical retinoids have been recently proposed to counteract the atrophogenic potential of topical glucocorticoid (12,13). It appears, therefore, that topical giucocorticoids and retinoids may have opposite activities in human skin that might have therapeutical applications; little data are available on the molecular mechanism of this interaction.…”

Section: Introductionmentioning

confidence: 99%

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Topical glucocorticosteroids modulate the expression of CRABP I and II in human skin differently

Piletta

Jaconi

Siegenthaler

et al. 1994

Experimental Dermatology

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Epidermal cells express two retinotic acid-binding proteins (CRABP I and II). Because CRABP II protein is strongly induced by topical retinoic acid, the respective roles of the two proteins in the pharmacological activity and toxicity of topical retinoids deserve particular attention. Since topical steroids diminish the irritation induced by retinoic acid (RA), whereas retinoic acid may counteract the atrophogenic effects of steroids, the possible interplay of both compounds in the expression of CRABP I and II appeared worth studying. We have analyzed the effects of topical application of triamcinolone acetonide (TA) on the retinoic acid-induced altered expression of CRABP I and II in normal human skin, at the protein and mRNA levels. We found that CRABP II protein and mRNA were strongly increased upon retinoic acid application: this induction was significantly inhibited by concomitant application of triamcinolone acetonide; a more potent steroid, difluocortolone valerate, was also found to diminish normal endogenous expression of CRABP II. In contrast, CRABP I protein was decreased by topical retinoic acid, and the down modulating effect of retinoic acid was counteracted by triamcinolone acetonide.

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Concurrent application of tretinoin (retinoic acid) partially protects against corticosteroid-induced epidermal atrophy

McMichael

Griffiths

Talwar

et al. 1996

British Journal of Dermatology

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Cutaneous atrophy arising from prolonged use of potent topical corticosteroids has long been a concern. Thus, it would be advantageous to find an agent which protects against atrophy produced by corticosteroids but at the same time does not impair their anti-inflammatory effects. Recent work shows that topical all-trans retinoic acid (tretinoin) prevents skin atrophy in mice treated with topical corticosteroids, but such studies have not been performed in humans. We performed an 8-week clinical, histological and biochemical study to test the ability of tretinoin to enhance efficacy and inhibit atrophogenicity of topical corticosteroids, when used in the treatment of psoriasis. In each of 20 psoriasis patients, one plaque, and its perilesional skin, was treated once daily with betamethasone dipropionate and tretinoin 0.1%, and one plaque, and its perilesional skin, treated with once daily betamethasone dipropionate and tretinoin vehicle. There was no difference in the speed or degree of improvement in plaques treated with either the topical corticosteroid/tretinoin combination or with corticosteroid alone. Light microscopy revealed a 19% reduction in epidermal thickness, in corticosteroid-treated perilesional skin, as compared with a slight (1%) increase in corticosteroid/tretinoin-treated perilesional areas (P = 0.067). Western blot analysis showed a 55% reduction in procollagen I aminopropeptide in perilesional skin treated corticosteroid alone, as compared with a 45% reduction in corticosteroid/tretinoin-treated perilesional skin. These data indicate that the addition of tretinoin does not impair the efficacy of a topical corticosteroid, in the treatment of psoriasis, and partially ameliorates epidermal atrophy produced by the topical corticosteroid.

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Topical Retinoic Acid Does Not Alter the Vasoconstrictive Properties of Topical Corticosteroids in Humans

Cited by 5 publications

References 12 publications

Treatment of Eczema with a Mixture of Triamcinolone Acetonide and Retinoic Acid A Double-Blind Study

Treatment of Eczema with a Mixture of Triamcinolone Acetonide and Retinoic Acid A Double-Blind Study

Topical glucocorticosteroids modulate the expression of CRABP I and II in human skin differently

Concurrent application of tretinoin (retinoic acid) partially protects against corticosteroid-induced epidermal atrophy

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