Retinoid Chemoprevention in High-Risk Skin Cancer Patients

Peter Reilly; John J. DiGiovanna

Disclosures

Dermatology Nursing. 2004;16(2) 

In This Article

Abstract and Introduction

More commonly known for their dramatic effects on acne and psoriasis for the past 20 years, systemic retinoids can be a valuable chemopreventive treatment option for those individuals in a wide variety of high-risk populations who are actively developing large numbers of sun-induced skin cancers.

Vitamin A is a dietary nutrient that is essential for normal growth and development. Retinoid is the term used for vitamin A, including its naturally occurring and synthetic derivatives. Retinoids play a major role in controlling the normal function of individual cells and of tissues. Within the cell, they control the regulation of differentiation, growth, and eventually, orderly cell death. Retinoids play an important role during embryogenesis, where they act as morphogens, exerting control over fetal development. For example, they control the spatial patterns of limb development. The importance of retinoids in regulating normal, orderly fetal development, is the reason why retinoid excess during fetal development is so detrimental, leading to teratogenic outcomes.

Since the 1960s, there has been great interest in the development of retinoids as drugs for dermatology (DiGiovanna, 2001a). Derivatives of vitamin A, such as tretinoin (all-trans retinoic acid), isotretinoin (13-cis retinoic acid), etretinate and acitretin (derivatives of all-trans retinoic acid) have transformed the treatment of a wide variety of dermatologic disorders. They can lead to dramatic responses in the treatment of acne, psoriasis, and disorders of cornification. Recently, they have been found to play promising roles in glucose control and lipid metabolism. A major force spurring retinoid development was their potential for treating and preventing malignancy. Retinoids are useful chemopreventive agents in high-risk populations prone to developing sun-induced skin cancers. In this article the role of systemic retinoid therapy in managing patients at high risk for developing skin cancer will be reviewed.

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