外用维A酸治疗皮肤病的进展

Topical retinoids for the treatment of skin diseases

维A酸由于具有抗增殖、抗炎、调节免疫、促进胶原生成等作用，目前已广泛治疗皮肤病。近年来临床上对于外用维A酸的研究主要针对不同种类、不同浓度维A酸之间的比较以及与其他药物联用的疗效及不良反应，并在瘢痕疙瘩、寻常痤疮、光老化、色素沉着性疾病以及再生效果等方面取得了一些新进展，但其抗皮肤肿瘤的疗效尚不确切。不同于系统应用，目前尚无证据表明外用维A酸可致胎儿畸形，但仍不推荐用于孕妇。外用维A酸的不良反应主要表现为局部皮肤刺激症状，口唇干燥等系统性不良反应可见，新型给药系统的发展优化了外用维A酸的理化性质，将进一步减少其不良反应并提高疗效。

Retinoids possess anti-proliferative, anti-inflammatory, immunoregulatory and pro-collagenogenic effects, and have been applied to the treatment of skin diseases. In recent years, clinical studies on topical retinoids have been mainly focused on comparisons among different classes and concentrations of retinoids, as well as therapeutic and adverse effects of them in combination with other drugs. Some progress has been made in their application to the treatment of keloid, acne vulgaris, photoaging, hyperpigmentation disorders, and regenerative effects, but their anti-tumor effects are still unclear. Unlike oral retinoids, there is no evidence that topical retinoids can cause fetal malformation. However, topical retinoids are not recommended for pregnant women yet. Adverse reactions to topical retinoids mainly manifest as local irritation, and systemic adverse reactions such as xerocheilia are also observed. The development of new drug delivery systems has optimized physicochemical properties of topical retinoids, and will further reduce adverse reactions and improve their therapeutic effects.