Favre-Racouchot Syndrome (Nodular Elastosis With Cysts and Comedones) Medication
- Author: Robert P Feinstein, MD; Chief Editor: Dirk M Elston, MD more...
Medication Summary
In general, the most effective medication has been the use of topical retinoids including tretinoin, adapalene, or tazarotene in various bases.
Retinoids
Class Summary
Treatment of choice in the elimination of comedones. These medications assist in the removal of the comedones and also may reduce the appearance of actinic damage in the area. More severe cases have been treated with oral isotretinoin, but oral therapy should be reserved for severe cases refractory to topical therapy.
Tretinoin topical (Avita, Retin-A)
Inhibits microcomedo formation and eliminates lesions present. Makes keratinocytes in sebaceous follicles less adherent and easier to remove. Available as 0.025, 0.05, and 0.1% creams. Available also as 0.01 and 0.025% gels. Cream formulations usually are well tolerated. Individuals may begin with the 0.025% cream. Those who do not respond to this concentration may require the 0.05% or 0.1% concentration.
Adapalene (Differin)
Modulates cellular differentiation, inflammation, and keratinization. May be tolerated by individuals who cannot tolerate tretinoin creams. A therapeutic response can be expected following 8-12 wk of therapy. Available as 0.1% gel or solution.
Tazarotene (Tazorac)
Retinoid prodrug whose active metabolite modulates differentiation and proliferation of epithelial tissue; may also have anti-inflammatory and immunomodulatory properties.
Isotretinoin (Accutane)
Oral agent that treats serious dermatologic conditions. Isotretinoin is the synthetic 13-cis isomer of the naturally occurring tretinoin (trans-retinoic acid). Both agents are structurally related to vitamin A.
Decreases sebaceous gland size and sebum production. May inhibit sebaceous gland differentiation and abnormal keratinization.
Should only be prescribed by individuals who are completely familiar with drug and appropriate prescribing practices and precautions.
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.
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