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April 1973

Epidermolytic Hyperkeratosis: Effect of Tretinoin Therapy on the Clinical Course and the Basic Defects in the Stratum Corneum

Author Affiliations

Marshfield, Wis

From the Department of Dermatology, Marshfield Clinic, and the Marshfield Clinic Foundation for Medical Research and Education, Marshfield, Wis, and Johnson & Johnson Laboratories, New Brunswick, NJ.

Arch Dermatol. 1973;107(4):556-562. doi:10.1001/archderm.1973.01620190032008

Three members of a family with severe epidermolytic hyperkeratosis were successfully treated with topical tretinoin therapy. During hospitalization a controlled paired-comparison study was performed treating one half of each patient with retinoic acid and the other half with the appropriate placebo. The retinoic acid was evaluated at concentrations 0.05% and 0.1% and in both an alcohol-polyethylene glycol solution as well as in a cream base. Special studies, using the scanning electron microscope, revealed basic alterations in the ultrastructure of diseased skin which help to explain the repeated pyodermas, persistent malodor, and lack, of a physiologically effective stratum corneum with the disorder. While the ineffective barrier function permitted systemic effects from topical corticosteroid applications in one patient, no adverse reactions were seen with prolonged, full-body tretinoin therapy over a period of eight months. Significant therapeutic results were recorded photographically.

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