Retinoids in Dermatology

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Abstract
For decades, dermatologists have been intrigued with the therapeutic possibilities of orally given vitamin A in the treatment of cutaneous disorders of keratinization. This interest may have stemmed from the observation that vitamin A deficiency led to a hyperkeratotic state mimicking diseases such as Darier's disease and pityriasis rubra pilaris (PRP). Hypothetically, it appeared that these diseases might in some way be related to vitamin A deficiency or might respond to vitamin A acting as a nonspecific "antikeratinizing" agent. The accumulated clinical experience with vitamin A (usually given in the form of retinol, retinyl acetate, or retinyl palmitate) has led to the conclusion that vitamin A is of occasional value when given in very large dosages, varying from 50,000 to 1,000,000 IU/ day, in the treatment of Darier's disease, PRP, and rarely acne vulgaris. At these dosage levels the hypervitaminosis A syndrome, particularly the bone, liver, and neurologic components, usually