Fernández VJM, Armario HJC

Idioma: Español
Referencias bibliográficas: 187
Paginas: 271-294
Archivo PDF: 389.62 Kb.

RESUMEN

Desde su introducción en la Dermatología hace 60 años, los retinoides han adquirido la condición de fármaco indispensable en nuestra especialidad. Este hecho se debe tanto a la observación de resultados efectivos en un alto número de procesos cutáneos como por las innovaciones que se han realizado tanto en su estructura como en su formulación. En la actualidad su efectividad y seguridad está bien establecida, tanto en formulaciones tópicas como sistémicas, en acné, psoriasis y fotoenvejecimiento. En los últimos años se han descrito nuevas indicaciones de los retinoides en dermatología entre las que caben destacar su uso en el tratamiento del cáncer cutáneo, o con fines cosméticos con buenos resultados en cicatrización de las heridas, estrías cutáneas en fases iniciales o alopecia androgenética. Los avances farmacológicos han permitido derivados de la vitamina A más efectivos y con menos efectos adversos. Tretinoina, aún con una mayor actividad irritante, sigue siendo el fármaco más efectivo por vía tópica en fotoenvejecimiento y cáncer cutáneo. Isotretinoina por vía oral es el fármaco de elección en el acné crónico y severo, adapaleno es la formulación tópica mejor tolerada en el acné, tazaroteno es el primer retinoide tópico con efectividad en psoriasis, etretinato y acitretino se consideran de elección en el tratamiento sistémico del psoriasis. Por último, se han descrito de forma reciente nuevas moléculas que han ampliado las indicaciones de los retinoides en dermatología, son alitretinoina para el sarcoma de Kaposi asociado a SIDA y bexaroteno para el linfoma cutáneo de células T.

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