Which medications in the drug class Retinoid-like Agents are used in the treatment of Cutibacterium (Propionibacterium) Infections?

Updated: Dec 03, 2019
  • Author: Sajeev Handa, MBBCh, BAO, LRCSI, LRCPI; Chief Editor: John L Brusch, MD, FACP  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, Avita, Altreno)

Inhibits microcomedo formation. Decreases cohesiveness of keratinocytes in sebaceous follicles, which allows for easy removal. Anti-inflammatory properties. Available as creams, gels, and lotions.

Adapalene (Differin)

Inhibits microcomedo formation. Decreases cohesiveness of keratinocytes in sebaceous follicles, which allows for easy removal. Has anti-inflammatory properties. Available as creams, lotions, and gels.

Tazarotene (Tazorac, Fabior)

Inhibits microcomedo formation. Decreases cohesiveness of keratinocytes in sebaceous follicles, which allows for easy removal. Has anti-inflammatory properties. Available as creams, foams, and gels.

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

Oral retinoid indicated for recalcitrant, nodulocystic acne. Addresses all four pathogenic factors involved in the development of acne, including follicular hyperkeratinization, inflammation, sebum production, and C 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. May adjust 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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