Oral Retinoids: Present Status

In 1980, oral retinoids, specifically Ro 10-9359 and 13-cis-retinoic acid, were recognized for their effectiveness in treating a range of skin conditions. A study involving 291 psoriasis patients showed a 61% positive response to Ro 10-9359, with 15% remaining lesion-free for over 6 months. High doses of this retinoid rapidly improved pustular psoriasis, and it was also beneficial for long-term treatment of ichthyosis due to lower toxicity. Darier's disease and severe acne cases responded well to retinoids, though topical management was preferred for acne due to side effects and its temporary nature. Lichen planus, particularly the mucosal erosive type, and other skin conditions like plantar warts and keratodermas also improved with retinoid treatment. Side effects included cheilitis and hair loss, the latter affecting about 30% of patients after a minimum total dose of 2.0 g. Moderate elevations in liver enzymes and serum lipids were noted, but laboratory parameters were generally stable. The document highlighted the teratogenic risks associated with retinoids, advising against pregnancy during and after treatment. Retinoids were seen as a potential replacement for systemic corticosteroids and cytostatics in dermatotherapy, with additional implications for cancer research due to their effects on epithelial tissues and cellular immune responses.