The Ichthyoses pp 232-243 | Cite as

Systemic Therapy

  • Heiko Traupe

Abstract

Retinoids are powerful substances providing an effective therapy for almost all keratinization defects and many other related scaling disorders [1, 6, 8, 40, 47]. The beneficial effect of vitamin A [27] and vitamin A acid [44] in the treatment of cornification disorders has been known for many years. As discussed in Sect. 7.1, topical therapy with vitamin A acid was severely hampered by its irritating property [44]. On the other hand, systemic treatment with vitamin A requires high doses and produces unacceptable side effects, now commonly referred to as hypervitaminosis A. The signs of hypervitaminosis A are increased brain pressure and considerable liver and skeletal toxicity. These possible side effects prevented the general use of vitamin A in cornification disorders. In the mid-1970s, Werner Bollag [3], working at the Hoffmann-La Roche laboratories in Switzerland, organized a program to synthesize analogues of vitamin A. Over a thousand compounds were developed and screened. By chemical modification of the retinoid acid molecule, less toxic retinoids such as etretinate, isotretinoin, and – very recently – acitretin, the first metabolite of etretinate, were obtained.

Keywords

Methotrexate Glucocorticoid Psoriasis Dermatitis Retinoid 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • Heiko Traupe
    • 1
  1. 1.Department of Human GeneticsUniversity of NijmegenHB NijmegenThe Netherlands

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