Retinoids for Keratinizing Diseases and Acne in Children

The use of retinoids in the pediatric patient

Oral retinoids are molecules derived from vitamin A that represent one of the most important steps forward in dermatologic therapeutics in the present century. The treatment of acne, severe psoriasis, and severe disorders of keratinization, prevalent diseases in children and adolescents, have radically changed since the advent of oral retinoids. Like most highly-effective medications, oral retinoids also have important untoward effects. Specialists, and in particular, dermatologists and pediatricians should be prepared to maneuver the delicate balance between therapeutic efficacy and side effects in order to give the pediatric patient the maximum benefit with the lowest possible risk.

Isotretinoin-associated pseudoporphyria

We present two patients who developed pseudoporphyria whilst taking isotretinoin (Roaccutane). At that time, both patients were receiving other agents which could be incriminated as causing their pseudoporphyria. However, it is significant that these other agents had been longstanding and that the porphyria-like cutaneous changes did not develop until after the introduction of the isotretinoin (Roaccutane). In both cases, withdrawal of the isotretinoin resulted in clinical improvement of their cutaneous signs. The interaction of isotretinoin and another agent, rather than isotretinoin independently, may be involved in the development of pseudoporphyria.