Oral retinoids and plasma lipids
Article first published online: 4 OCT 2013
© 2013 Wiley Periodicals, Inc.
Special Issue: Effects and Side Effects of Topical and Systemic Retinoids
Volume 26, Issue 5, pages 404–410, September/October 2013
How to Cite
Lilley, J. S., Linton, M. F. and Fazio, S. (2013), Oral retinoids and plasma lipids. Dermatologic Therapy, 26: 404–410. doi: 10.1111/dth.12085
- Issue published online: 4 OCT 2013
- Article first published online: 4 OCT 2013
- drug-induced dyslipidemia;
- secondary hypertriglyceridemia
Retinoids and rexinoids are prescribed for conditions ranging from acne vulgaris to hyperkeratosis to cutaneous T cell lymphoma. Dyslipidemia is a frequent consequence of the use of these drugs, with more than one-third of patients manifesting aberrations in triglyceride (TG) levels. The efficacy of retinoic acid derivatives is linked to their influence on lipid metabolism in the skin, which can impair systemic lipid trafficking and metabolism in some patients. Thus, baseline screening for preexisting dyslipidemia and regular follow-up lipid panels are mandated, especially when powerful agents such as bexarotene are used. Dietary modification, increased physical activity, and weight management are the cornerstones of initial management for mild hypertriglyceridemia, which is a contributor to cardiovascular risk. More severe impairments (fasting TG > 500 mg/dL) warrant pharmacologic interventions early on to reduce the risk of pancreatitis. Retinoic acid derivative action, lipid metabolism, and treatment of incident dyslipidemias are reviewed to empower prescribers in management of adverse lipid effects.