Use of Vitamin a in the Treatment of Cutaneous Diseases

Keddie, Frances

doi:10.1001/archderm.1948.01520200067009

Cited by 19 publications

(4 citation statements)

References 31 publications

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“…I) has long been known for its importance in promoting general growth, in regulating proliferation and differentiation of epithelial tissues and in maintaining visual function and reproduction. Retinol (vitamin A) was introduced for the treatment of various skin diseases more than 40 years ago (Keddie 1948). Because oral therapy with retinol was associated with toxicity, including fatigue, headache, cheilitis, anorexia, peeling of the skin, pseudotumour cerebri, papillary oedema, hepatotoxicity, skeletal changes and lipid abnormalities (Korner & Vollum 1975), the use of retinol as an orally administered drug declined.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and Therapeutic Efficacy of Retinoids in Skin Diseases

Larsen

Nielsen‐Kudsk

Jakobsen

et al. 1992

Clinical Pharmacokinetics

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The retinoids are a class of compounds that includes the natural forms and synthetic analogues of vitamin A. Isotretinoin, often referred to as a first generation retinoid, may be of considerable benefit to patients with severe, recalcitrant acne. Etretinate and acitretin, 2 aromatic compounds representing the second generation, have found their major success in the treatment of psoriasis, particularly in combination with more traditional therapies. Retinoid therapy is associated with a distinctive adverse effect profile typical of hypervitaminosis A; thus, it is especially important that fertile women undergoing retinoid therapy adhere to a contraceptive regimen. These drugs are extensively metabolised and only traces of unchanged drugs are eliminated in urine. The terminal elimination half-lives of isotretinoin, etretinate and acitretin after long term treatment are up to 20h, 120 days and 48h, respectively. Because of lack of definite correlation between plasma concentration and desired pharmacological effects, in conjunction with the very pronounced inter- and intraindividual variation in systemic availability (15 to 90%) after oral administration of these drugs, initial dosages in individual patients can only be roughly judged on the basis of the general pharmacokinetics of the agents. Later dosage adjustments should be made on the basis of monitoring of both plasma drug (and possible metabolite) concentrations, and the efficacy and tolerability of the drugs.

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and Therapeutic Efficacy of Retinoids in Skin Diseases

Larsen

Nielsen‐Kudsk

Jakobsen

et al. 1992

Clinical Pharmacokinetics

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“…The hypervitaminosis A syndrome (STRAUMFJORD 1942;KEDDIE 1948) and its resemblance to various dermatoses was the reason for the therapeutic application of vitamin A and later of all-trans retinoic acid (FRY and SCHOCH 1952;BEER 1962;SnJTTGEN 1962;FULTON et al 1968;FROST and WEINSTEIN 1969;KLIGMAN et al 1969;FRY et al 1970;BOLLAG and OTT 1971;ORFANOS et al 1973). Compared with vitamin A, all-trans-retinoic acid proved to be highly efficient in patients with acne, psoriasis, genodermatoses, actinic keratoses, and basaliomas.…”

Section: A General Aspectsmentioning

confidence: 99%

Pharmacology of the Skin II

1989

Handbook of Experimental Pharmacology

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PrefaceThe recent interest in the pharmacology of the skin and the treatment of its diseases has come about for two reasons. The first is a realisation that many aspects of pharmacology can be studied as easily in human skin as in animal models, where they may be more relevant to human physiology and disease. Examples of this are the action of various vasoactive agents and the isolation of mediators of inflammation after UV irradiation and antigen-induced dermatitis. The second reason is the fortuitous realisation that a pharmacological approach to the treatment of skin disease need not always await the full elucidation of aetiology and mechanism. For example, whilst the argument continued unresolved as to whether the pilo-sebaceous infection which constitutes acne was due to a blocked duct or to a simple increase in sebum production, 13-cis retinoic acid, was found quite by chance totally to ablate the disease; again, whilst cyclosporin, fresh from its triumphs in organ transplantation, has been found able to suppress the rash of psoriasis, it has resuscitated the debate on aetiology.We are therefore entering a new era in which the pharmacology and clinical pharmacology of skin are being studied as a fascinating new way of exploring questions of human physiology and pharmacology as well as for the development and study of new drugs, use of which will improve disease control and at the same time help to define pathological mechanisms.It was because of this burgeoning interest in pharmacology of skin and its diseases, that this book came about. Indeed it is long overdue and was planned several years ago; we console ourselves with the thought that the delay may have served to help define certain principles which were then only just emerging.The book is divided into two volumes which are independent but complementary; the first being an account of the general pharmacology of skin, the second volume being more concerned with disease and drugs. The first volume is divided into two parts, the one dealing with the pharmacology of skin systems and their control and the other with autocoids in normal and inflamed skin. This second volume has three parts; the first part deals with the methods of measurement which are becoming of increasing importance both in studying the pharmacological effects of drugs and the clinical pharmacology of skin; the second deals with toxicology in its widest sense -including metabolism and percutaneous absorption; and the third is an account both of specific drugs and the drugs used for specific diseases.

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“…Satisfactory c1inical responses have been reported in common skin diseases such as acne vu1caris (Davidson and Sobel,1949), sorne eczemas (Gross,1941;Stroesser and Eelson,1952) and psoriasis (Schwartz,1950), as ·nell as in ether disorders ctaracterized chief1y ~' fo11icu1ar hyperkeratosis (Spies, 1947), Sorne patients ni th rare familial diseases such as Darier 1 s disease (keratosis follicularis), Devergie 1 s disease (pityriasis rubra pi1aris) and ichthyosis have a1so responded favourably to vitamin A therapy (Lei tner and l.ioore, 1048;Lei tner, 194 7;Keddie, 1948; Ra pa port et a1,1942), Law serum 1eve1s of vitamin A h2ve been reported in sorne dermato1ozic patients (Chieffi and Kirk,l949;Leitner,1947;Lahiri and Scandrett,l954). The increased blood levels that follm·ied int~msive vitanin .A therapy, hor1ever, were not always corre1ated with clinical responses in the same patients (Leitner and Loore,l<;L;C; Cornble )t,l954), In psM.ents '>'lith Darier 1 s disease or pityriasis rubra it bas been reported that liver function is impaired (Leitner :::nd t:oore,l948; Leitner, 1947;Keddie ,194[;).…”

Section: B Clinical Use Of Vitamin a In Dermatologymentioning

confidence: 99%

The effect of vitamin A in hyperkeratotic mouse mutants

Mauer

1961

J. Exp. Zool.

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Use of Vitamin a in the Treatment of Cutaneous Diseases

Cited by 19 publications

References 31 publications

Pharmacokinetics and Therapeutic Efficacy of Retinoids in Skin Diseases

Pharmacokinetics and Therapeutic Efficacy of Retinoids in Skin Diseases

Pharmacology of the Skin II

The effect of vitamin A in hyperkeratotic mouse mutants

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