Which medications in the drug class Retinoid-Like Agents are used in the treatment of Acneiform Eruptions?

Updated: Jul 29, 2019
  • Author: Julianne H Kuflik, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Retinoid-Like Agents

These agents stimulate cellular retinoid receptors and help normalize keratinocyte differentiation and are comedolytic. In addition, they have anti-inflammatory properties. Oral isotretinoin also reduces sebum production in the skin. Retinoids are classified into 3 generations. The first comprises topical tretinoin and systemic isotretinoin. Acitretin is a second-generation retinoid used to treat psoriasis. The third-generation retinoids include topical adapalene and tazarotene.

Topical tretinoin (Retin-A Micro, Atralin, Tretin-X Avita)

Topical tretinoin inhibits microcomedo formation. It decreases the cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory properties. Topical tretinoin is available as creams and gels.

Adapalene (Differin)

Adapalene inhibits microcomedo formation. It decreases the cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory properties and is available as creams and gels.

Tazarotene (Tazorac)

Tazarotene inhibits microcomedo formation. It decreases the cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory properties and is available as creams and gels.

Isotretinoin (Claravis, Amnesteem, Sotret, Myorisan)

Isotretinoin is an oral retinoid indicated for recalcitrant, nodulocystic acne. It addresses all four pathogenic factors involved the development of acne: follicular hyperkeratinization, inflammation, sebum production, and Cutibacterium acnes (formerly Propionibacterium acnes)growth. Treatment is weight-based, usually dosed initially 0.5 mg/kg and increased to 1 mg/kg in 2 divided doses for 15-20 weeks. Once-daily dosing is not recommended. One may adjust the dose to administer up to 2 mg/kg/day. Patients must be registered into government regulated iPledge program in order to receive the medication.


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