Medication Summary
The goal of pharmacotherapy is to reduce morbidity and prevent complications.
Retinoids
Class Summary
Retinoids decrease the cohesiveness of abnormal hyperproliferative keratinocytes and may reduce the potential for malignant degeneration. These agents modulate keratinocyte differentiation. They have been shown to reduce the risk of skin cancer in patients who have undergone renal transplantation.
Tretinoin 0.025 to 0.1% (Retin-A, Avita)
Keratolytic agent. Acts by increasing epidermal cell mitosis and turnover while suppressing keratin synthesis. Important side effect of interest is hypopigmentation, which reduces the appearance of lentigines.
Bleaching creams
Class Summary
These agents lighten hyperpigmented skin by inhibiting enzymatic oxidation of tyrosine and by suppressing other melanocyte metabolic processes, thereby further inhibiting melanin production.
Hydroquinone (Eldopaque-Forte, Solaquin Forte, Lustra)
Suppresses melanocyte metabolic processes, especially enzymatic oxidation of tyrosine to 3,4-dihydroxyphenylamine. Exposure to sun reverses effects and causes repigmentation.
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