Which medications in the drug class Retinoid-like Agents are used in the treatment of Porokeratosis?

Updated: Oct 09, 2020
  • Author: Amarateedha Prak LeCourt, MD; Chief Editor: William D James, MD  more...
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Answer

Retinoid-like Agents

These agents decrease the cohesiveness of abnormal hyperproliferative keratinocytes and may reduce the potential for malignant degeneration. They modulate keratinocyte differentiation and have been shown to reduce the risk of skin cancer formation in patients who have undergone renal transplantation.

Tretinoin topical (Retin-A, Renova, Atralin, Tretin X)

Tretinoin topical inhibits microcomedo formation and eliminates lesions. It makes keratinocytes in sebaceous follicles less adherent and easier to remove. It is used primarily to treat acne but has beneficial effects on actinic keratoses and may reduce the malignant potential of porokeratosis. Tretinoin topical is available as 0.025%, 0.05%, and 0.1% creams and 0.01% and 0.025% gels.

Isotretinoin (Amnesteem, Claravis, Myorisan, Sotrel)

Isotretinoin is an oral agent that treats serious dermatologic conditions. It is a synthetic 13-cis isomer of naturally occurring tretinoin (trans-retinoic acid). Both agents are structurally related to vitamin A. Isotretinoin decreases sebaceous gland size and sebum production. It may inhibit sebaceous gland differentiation and abnormal keratinization. It treats severe recalcitrant cystic acne and appears to help in the treatment of porokeratosis.

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 second-generation monoaromatic retinoid and active metabolite of etretinate. It has demonstrated clinical effects close to those seen with etretinate. Its mechanism of action is unknown. No studies have looked at its effect on porokeratosis.


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