Retinoids act through regulating cell differentiation, cell proliferation and apoptosis.They have immunomodulatory and anti-inflammatory effects. Though the mechanism of actions are similar, some retinoids like Acitretin, Isotretinoin, Bexarotene are not effective in CHE but Alitretinoin is effective. What is/ are the underlying causes of this difference in action?
Intersting question. Will need to refresh. Though we see such cases daily. Yesterday I introduced Adapalene to CHE Patient. I hope she will be available for follow up shortly.
There are many reasons and explanations. In the first line it is on one side a question of the drug's pharmacodynamics and pharmacokinetiks, and on the other side a matter of the individual organism response. Since the diagnosis of chronic hand eczema encompasses a number of different conditions, one can not expect the same therapeutic response, even if clinically the conditions are very similar. I am not sure that we really completely do know and understand the ethiopathogenesis of these diseases, and also the mode of action of retinoids. And that is the reason why pharmacotherapy is more a skill than a precise scientific procedure, although it should as much as possible always be the latter.
Marko. Vok.
Sir. Its a very good answer explanation of the reality of situations.