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Clinical and Experimental Dermatology Jul 2015Alitretinoin is an endogenous vitamin A derivative, 9-cis-retinoic acid. Its anti-inflammatory and immunomodulatory efficacy results from controlling leukocyte activity... (Review)
Review
Alitretinoin is an endogenous vitamin A derivative, 9-cis-retinoic acid. Its anti-inflammatory and immunomodulatory efficacy results from controlling leukocyte activity and cytokine production in keratinocytes. We describe three patients with severe chronic hand eczema accompanied by nail dystrophy, which was treated with alitretinoin 30 mg. Clinical evaluation at 6 months showed complete or almost complete clearing of the nail lesions. We also briefly review the literature reporting on nail dystrophy and alitretinoin treatment. There is some evidence of the clinical effect of retinoids on nail formation, owing to the presence of retinoid receptors on the nail matrix. Further studies are required to better understand the impact of alitretinoin in nail diseases. Our observation supports alitretinoin as a treatment option in retinoid-responsive dermatoses associated with nail involvement.
Topics: Adult; Alitretinoin; Anti-Inflammatory Agents; Chronic Disease; Dermatologic Agents; Eczema; Female; Hand Dermatoses; Humans; Male; Middle Aged; Nail Diseases; Treatment Outcome; Tretinoin
PubMed: 25682921
DOI: 10.1111/ced.12584 -
Contact Dermatitis Oct 2021Patients taking part in a tertiary individual prevention program (TIP) for work-related skin diseases frequently have chronic hand eczema (HE) for which alitretinoin is...
BACKGROUND
Patients taking part in a tertiary individual prevention program (TIP) for work-related skin diseases frequently have chronic hand eczema (HE) for which alitretinoin is a treatment option.
OBJECTIVE
To investigate treatment with alitretinoin before and during the TIP and related factors.
METHODS
Data of 1614 patients taking part in the TIP between January 2015 and December 2019 were analyzed retrospectively.
RESULTS
Three hundred forty-eight patients (21.6%) reported treatment with alitretinoin prior to the TIP showing an increase over time, particularly in men. In 45 patients (2.8%), alitretinoin treatment was initiated during the TIP. Treatment with alitretinoin was significantly less common among female than male patients, both prior to (P < .001) and during the TIP (P = .015). Female patients who had received alitretinoin in the past were significantly older than the other female patients (P < .001). Among patients treated with alitretinoin prior to the TIP, women had a significantly higher disease severity at admission than men (P = .007).
CONCLUSIONS
About twenty percent of patients reported treatment with alitretinoin prior to the TIP. The data indicate that treatment of female TIP patients with alitretinoin is less frequent than among male patients and depends on age and disease severity.
Topics: Adolescent; Adult; Age Factors; Aged; Alitretinoin; Dermatitis, Occupational; Dermatologic Agents; Female; Hand Dermatoses; Humans; Male; Middle Aged; Retrospective Studies; Severity of Illness Index; Young Adult
PubMed: 33966276
DOI: 10.1111/cod.13883 -
American Journal of Health-system... Feb 2002
Topics: Alitretinoin; Antineoplastic Agents; Counseling; Drug Interactions; Humans; Sarcoma, Kaposi; Tretinoin
PubMed: 11885395
DOI: No ID Found -
Der Hautarzt; Zeitschrift Fur... Oct 2013Oral alitretinoin (9-cis retinoic acid) is an endogenous retinoid related to vitamin A. Studies have shown that oral alitretinoin is effective and well-tolerated in the... (Review)
Review
Oral alitretinoin (9-cis retinoic acid) is an endogenous retinoid related to vitamin A. Studies have shown that oral alitretinoin is effective and well-tolerated in the treatment of severe chronic hand eczema, so that it is approved for this indication. This review summarizes new studies and clinical experience on the off-label use of alitretinoin.
Topics: Alitretinoin; Chronic Disease; Dermatologic Agents; Drug-Related Side Effects and Adverse Reactions; Eczema; Evidence-Based Medicine; Hand Dermatoses; Humans; Off-Label Use; Treatment Outcome; Tretinoin
PubMed: 24150823
DOI: 10.1007/s00105-013-2593-2 -
International Journal of Molecular... Jun 2023Retinoids are a frequently used class of drugs in the treatment of inflammatory as well as malignant skin diseases. Retinoids have differential affinity for the retinoic...
Retinoids are a frequently used class of drugs in the treatment of inflammatory as well as malignant skin diseases. Retinoids have differential affinity for the retinoic acid receptor (RAR) and/or the retinoid X receptor (RXR). The endogenous dual RAR and RXR agonist alitretinoin (9- retinoic acid) demonstrated remarkable efficacy in the treatment of chronic hand eczema (CHE) patients; however, detailed information on the mechanisms of action remains elusive. Here, we used CHE as a model disease to unravel immunomodulatory pathways following retinoid receptor signaling. Transcriptome analyses of skin specimens from alitretinoin-responder CHE patients identified 231 significantly regulated genes. Bioinformatic analyses indicated keratinocytes as well as antigen presenting cells as cellular targets of alitretinoin. In keratinocytes, alitretinoin interfered with inflammation-associated barrier gene dysregulation as well as antimicrobial peptide induction while markedly inducing hyaluronan synthases without affecting hyaluronidase expression. In monocyte-derived dendritic cells, alitretinoin induced distinct morphological and phenotypic characteristics with low co-stimulatory molecule expression (CD80 and CD86), the increased secretion of IL-10 and the upregulation of the ecto-5'-nucleotidase CD73 mimicking immunomodulatory or tolerogenic dendritic cells. Indeed, alitretinoin-treated dendritic cells demonstrated a significantly reduced capacity to activate T cells in mixed leukocyte reactions. In a direct comparison, alitretinoin-mediated effects were significantly stronger than those observed for the RAR agonist acitretin. Moreover, longitudinal monitoring of alitretinoin-responder CHE patients could confirm in vitro findings. Taken together, we demonstrate that the dual RAR and RXR agonist alitretinoin targets epidermal dysregulation and demonstrates strong immunomodulatory effects on antigen presenting cell functions.
Topics: Humans; Alitretinoin; Retinoids; Tretinoin; Receptors, Retinoic Acid; Retinoid X Receptors; Antigen-Presenting Cells
PubMed: 37298605
DOI: 10.3390/ijms24119654 -
Journal of the American Academy of... Sep 2012
Topics: Adult; Aged; Aged, 80 and over; Alitretinoin; Female; Humans; Lupus Erythematosus, Cutaneous; Male; Off-Label Use; Retinoid X Receptors; Tretinoin
PubMed: 22890744
DOI: 10.1016/j.jaad.2011.10.030 -
Journal of the European Academy of... Jun 2019
Topics: Alitretinoin; Dermatologic Agents; Diagnosis, Differential; Humans; Hyperpigmentation; Male; Middle Aged; Skin Diseases, Genetic; Skin Diseases, Papulosquamous
PubMed: 30742719
DOI: 10.1111/jdv.15485 -
Acta Dermatovenerologica Alpina,... Dec 2023Darier disease is a rare autosomal dominant genodermatosis that initially first presents in adolescence with scaly reddish brown keratotic papules and plaques with a...
Darier disease is a rare autosomal dominant genodermatosis that initially first presents in adolescence with scaly reddish brown keratotic papules and plaques with a seborrheic and intertriginous distribution. The absence of specific targeted medications complicates the treatment process, and managing resistant cases can prove challenging due to recurrent exacerbations that may result in serious complications such as secondary bacterial and viral infections. Treatments of choice include antiseptics, topical corticosteroids, and systemic retinoids, mainly acitretin and isotretinoin. We report the case of a female patient with Darier disease that was unsuccessfully treated with acitretin and isotretinoin but showed significant improvement with alitretinoin. Previous reports on the efficacy of alitretinoin in Darier disease are reviewed.
Topics: Adolescent; Humans; Female; Darier Disease; Alitretinoin; Acitretin; Isotretinoin; Dermatologic Agents
PubMed: 38126103
DOI: No ID Found -
The British Journal of Dermatology May 2016
Topics: Administration, Oral; Alitretinoin; Dermatologic Agents; Female; Foot Dermatoses; Hand Dermatoses; Humans; Keratoderma, Palmoplantar; Treatment Outcome; Tretinoin; Young Adult
PubMed: 26617313
DOI: 10.1111/bjd.14327 -
Acta Dermato-venereologica Dec 2023
Topics: Humans; Alitretinoin; Mycosis Fungoides; Skin Neoplasms
PubMed: 38088788
DOI: 10.2340/actadv.v103.18472