Which medications in the drug class Retinoids are used in the treatment of Hidradenitis Suppurativa?

Updated: Aug 30, 2019
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Answer

Retinoids

Vitamin A derivatives have many roles. They encourage cellular differentiation, are antiproliferative, and serve as immunomodulators.

Isotretinoin (Amnesteem, Claravis, Absorica, Myorisan, Zenatane)

Isotretinoin affects epidermal differentiation, especially at the follicular infundibulum, has immunomodulating effects, and has been used as chemoprophylaxis for skin cancers.

A US Food and Drug Administration–mandated registry is now in place for all individuals prescribing, dispensing, or taking isotretinoin. For more information on this registry, see iPLEDGE. This registry aims to further decrease the risk of pregnancy and other unwanted and potentially dangerous adverse effects during a course of isotretinoin therapy.

Acitretin (Soriatane)

Acitretin is a metabolite of etretinate. Specifically, acitretin helps to normalize cell differentiation and thin the cornified layer, by directly reducing the keratinocytes’ rate of proliferation. This is why it is reasonable to suggest acitretin usage in early hidradenitis suppurativa stages (Hurley I or mild II), and perhaps even in the later stages of hidradenitis suppurativa. Recommended doses administered over 3-12 months for acitretin and etretinate ranged from 0.25-0.88 mg/kg and 0.35-1.1 mg/kg, respectively. Pregnancy testing should be done monthly during the whole period of treatment and preferably at 1-3 monthly intervals after therapy cessation for a period of at least 2 years (3 years according to US labelling).


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