An overview about Therapeutic uses, clinical efficacy, safety and classes of Retinoids and its efficacy for Treatment of skin aging
DOI:
https://doi.org/10.32792/utq/utjsci/v10i1.914Keywords:
Retinoidskin, photoaging, vitamin AAbstract
Abstract Skin aging has both underlying and extraneous factors. the outermost organ of the human body, the skin suffers from environmental damage to agents such as air pollution and cigarette smoking, the resulting skin aging is called extraneous aging, which is also known as photoaging or the exposure to sunlight via UV radiation. Retinoid refers to the synthetic and natural analogues of vitamin A. Retinoids are a class of compounds derived from vitamin A or showing structural and/or functional similarities to vitamin A. Retinoids as dermatological agents that are widely applied in cosmetics and effective against acne, psoriasis, skin aging, and other skin conditions. Their susceptibility to degradation is a limiting factor for their widespread use, In other words; retinoid concentration in cosmetics is restricted, and one particular form–retinoic acid, is banned due to safety reasons. These include retinol, retinal, tretinoin (retinoic acid), isotretinoin, and alitretinoin, etretinate, adapalene, bexarotene, tazarotene, and Trifarotene. The aim of this review is to introduce the different uses of different types of retinoid in cosmetic and dermatological treatments.
Key words: Retinoids, skin, photoaging, vitamin A
References
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8-Fritz, Heidi, et al. "Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis." PloS one 6.6 (2011): e21107.
9-Kolli, Sree S., et al. "Topical retinoids in acne vulgaris: a systematic review." American Journal of Clinical Dermatology 20.3 (2019): 345-365.
10-Higdon, Jane, V. J. Drake, and B. Delage. "Vitamin A Linus Pauling Institute, Oregon State University." (2010).
11-Kulier, R., A. M. Gülmezoglu, and J. Villar. "Vitamin A supplementation during pregnancy." The Cochrane Database of Systematic Reviews 4 (2002): CD001996-CD001996.
12-Temova Rakuša, Žane, et al. "Retinoid stability and degradation kinetics in commercial cosmetic products." Journal of cosmetic dermatology 20.7 (2021): 2350-2358.
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15-Chandraratna, R. A. S. "Future trends: a new generation of retinoids." Journal of the American Academy of Dermatology 39.4 (1998): S149-S152.
16-Schapira, Matthieu, et al. "Rational discovery of novel nuclear hormone receptor antagonists." Proceedings of the National Academy of Sciences 97.3 (2000): 1008-1013.
17- Krutmann, Jean, et al. "Environmentally-induced (extrinsic) skin aging: Exposomal factors and underlying mechanisms." Journal of Investigative Dermatology 141.4 (2021): 1096-1103.
18- Tigges, J., Krutmann, J., Fritsche, E., Haendeler, J., Schaal, H., Fischer, J. W., ... & Boege, F. (2014). The hallmarks of fibroblast ageing. Mechanisms of ageing and development, 138, 26-44.
19- Gu, Yanpei, et al. "Biomarkers, oxidative stress and autophagy in skin aging." Ageing research reviews 59 (2020): 101036.
20- Cai, Liqi, et al. "Characteristic of microplastics in the atmospheric fallout from Dongguan city, China: preliminary research and first evidence." Environmental Science and Pollution Research 24.32 (2017): 24928-24935.
21- Vierkötter, Andrea, et al. "Airborne particle exposure and extrinsic skin aging." Journal of investigative dermatology 130.12 (2010): 2719-2726.
22- Kebriaei, Partow, et al. "Phase I trials using Sleeping Beauty to generate CD19-specific CAR T cells." The Journal of clinical investigation 126.9 (2016): 3363-3376.
23- Dattler, Damien, et al. "Design of collective motions from synthetic molecular switches, rotors, and motors." Chemical reviews 120.1 (2019): 310-433.
24- F. Flament, R. Bazin, H. Qiu, C. Ye, S. Laquieze, V. Rubert, et al.Solar exposure(s) and facial clinical signs of aging in Chinese women: impacts upon age perception Clin Cosmet Investig Dermatol, 8 (2015), pp. 75-84
25- Pilkington, Suzanne M., et al. "Inflammaging and the Skin." Journal of Investigative Dermatology 141.4 (2021): 1087-1095
26- Deng, Sophie X., et al. "Global consensus on the definition, classification, diagnosis and staging of limbal stem cell deficiency." Cornea 38.3 (2019): 364.
27- M.R. Iannacone, M.C. Hughes, A.C. Green Effects of sunscreen on skin cancer and photoaging Photodermatol Photoimmunol Photomed, 30 (2014), pp. 55-61
28- J. Krutmann, B.A. Gilchrest Photoaging of skin B.A. Gilchrest, J. Krutmann (Eds.), Skin aging, Springer, Heidelberg (2006), pp. 33-43
29- Krutmann, Jean, et al. "The skin aging exposome." Journal of dermatological science 85.3 (2017): 152-161.).
30- Aizen, Efraim, and Amos Gilhar. "Smoking effect on skin wrinkling in the aged population." International journal of dermatology 40.7 (2001): 431-433.
31- Reilly, David M., and Jennifer Lozano. "Skin collagen through the lifestages: Importance for skin health and beauty." Plastic and Aesthetic Research 8 (2021): 2.
32- Carazo, Alejandro, et al. "Vitamin A update: Forms, sources, kinetics, detection, function, deficiency, therapeutic use and toxicity." Nutrients 13.5 (2021): 1703.
33- Rusu, Aura, et al. "Recent advances regarding the therapeutic potential of adapalene." Pharmaceuticals 13.9 (2020): 217.
34- Zasada, Malwina, and Elżbieta Budzisz. "Retinoids: Active molecules influencing skin structure formation in cosmetic and dermatological treatments." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 36.4 (2019): 392-397.
35- Rhinn, Muriel, and Pascal Dollé. "Retinoic acid signalling during development." Development 139.5 (2012): 843-858.
36- Wiesinger, Alexandra, et al. "Retinoic acid signaling in heart development: application in the differentiation of cardiovascular lineages from human pluripotent stem cells." Stem Cell Reports 16.11 (2021): 2589-2606.
37- Michalak, Monika, et al. "Bioactive compounds for skin health: A review." Nutrients 13.1 (2021): 203.
38- Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945–973.e33.
39- Leyden, James J. "The role of isotretinoin in the treatment of acne: personal observations." Journal of the American Academy of Dermatology 39.2 (1998): S45-S49.
40- Motamedi, Melika, et al. "A Clinician’s Guide to Topical Retinoids." Journal of Cutaneous Medicine and Surgery 26.1 (2022): 71-78.
41- Thielitz A., Abdel-Naser MB., Fluhr JW., Zouboulis CC., Gollnick H. Topical retinoids in acne - an evidence-based overview. J Dtsch Dermatol Ges. 2008;6(12):1023-1031
42- Lam, Kaitlyn, and Ronald Vender. "Mechanism of action of acitretin." Retinoids in Dermatology. CRC Press, 2019. 27-31.
43- Pearce DJ, Klinger S, Ziel KK, Murad EJ, Rowell R, Feldman SR. Low-dose acitretin is associated with fewer adverse events than high-dose acitretin in the treatment of psoriasis. Arch Dermatol. 2006 Aug;142(8):1000–4.
44- Woodley DT, Zelickson AS, Briggaman RA, et al. Treatment of photoaged skin with topical tretinoin increases epidermal-dermal anchoring fibrils. a preliminary report. JAMA. 1990;263:3057-3059.
45- Olsen EA, Katz I, Levine N, et al. Tretinoin emollient cream:
a new therapy for photodamaged skin. J Am Acad Dermatol.
1992;26:215-224.
46- Clinical effects of long-term therapy with topical tretinoin and cellular mode of action
47- Zhu, Shengqian, et al. "Protective Effect of Fat-Tissue–Derived Products against Ultraviolet Irradiation–Induced Photoaging in Mouse Skin." Plastic and Reconstructive Surgery 148.6 (2021): 1290-1299.
48- Reszko, Anetta E., Diane Berson, and Mary P. Lupo. "Cosmeceuticals: practical applications." Dermatologic clinics 27.4 (2009): 401-416.
49- Kang S, Duell EA, Fisher GJ, et al. Application of retinol to
human skin in vivo induces epidermal hyperplasia and cellular
retinoid binding proteins characteristic of retinoic acid but without measurable retinoic acid levels or irritation. J Invest Dermatol.
1995;105:549-556.
50- BOWES, LORNA. "Topical vitamin A: types and applications in aesthetic medicine." Journal of Aesthetic Nursing 8.3 (2019): 106-115.
51- Fields, Jaime R., et al. "Topical ketoconazole for the treatment of androgenetic alopecia: a systematic review." Dermatologic therapy 33.1 (2020): e13202.
52- Ferreira, Rafael M., et al. "Unravelling potential virulence factor candidates in Xanthomonas citri. subsp. citri by secretome analysis." PeerJ 4 (2016): e1734.
53- Roeder A, Schaller M, Schäfer-Korting M, Korting HC. Tazarotene: therapeutic strategies in the treatment of psoriasis, acne and photoaging. Skin Pharmacol Physiol. 2004 May-Jun;17(3):111-8. doi: 10.1159/000077236. PMID: 15087589.
54- Nagpal, Sunil, et al. "Tazarotene-induced gene 2 (TIG2), a novel retinoid-responsive gene in skin." Journal of Investigative Dermatology 109.1 (1997): 91-95.
55- DiSepio, Daniel, et al. "Identification and characterization of a retinoid-induced class II tumor suppressor/growth regulatory gene." Proceedings of the National Academy of Sciences 95.25 (1998): 14811-14815.
56- Williams, Amy Lavin, Nelson D. Pace, and John M. DeSesso. "Teratogen update: topical use and third‐generation retinoids." Birth defects research 112.15 (2020): 1105-1114.
57- Rusu, Aura, et al. "Recent advances regarding the therapeutic potential of adapalene." Pharmaceuticals 13.9 (2020): 217.
58- Tolaymat, Leila, Heidi Dearborn, and Patrick M. Zito. "Adapalene." StatPearls [Internet]. StatPearls Publishing, 2022.
59- Otlewska, Agnieszka, Wojciech Baran, and Aleksandra Batycka-Baran. "Adverse events related to topical drug treatments for acne vulgaris." Expert Opinion on Drug Safety 19.4 (2020): 513-521.
60- Leyden, Dennis P., and Matthias Menter. "The impact of knowledge transfer on innovation: exploring the cross-fertilization of basic and applied research." Handbook of Technology Transfer. Edward Elgar Publishing, 2022. 25-38.
61- Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
62- Draelos ZD. Novel approach to the treatment of hyperpigmented photodamaged skin: 4% hydroquinone/0.3% retinol versus tretinoin 0.05% emollient cream. Dermatol Surg. 2005;31:799-804.
63- Draelos Z, Lewis J, McHugh L, Pellegrino A, Popescu L. Novel retinoid ester in combination with salicylic acid for the treatment of acne. J Cosmet Dermatol. 2016 Mar;15(1):36-42. doi: 10.1111/jocd.12190. Epub 2015 Oct 30. PMID: 26516077.
64- Ruamrak, C., N. Lourith, and S. Natakankitkul. "Comparison of clinical efficacies of sodium ascorbyl phosphate, retinol and their combination in acne treatment." International journal of cosmetic science 31.1 (2009): 41-46.
65- Pfannschmidt N, Bauer R, Kreysel HW. [Combined topical treatment of acne with erythromycin and tretinoin]. Zeitschrift fur Hautkrankheiten. 1988 May;63(5):366-8, 373. PMID: 2970158.
66- Ramachandran, Vignesh, et al. "Treating psoriasis with halobetasol propionate and tazarotene combination: a review of phase II and III clinical trials." Annals of Pharmacotherapy 54.9 (2020): 872-878.
2- Theodoridis A, Makrantonaki E, Zouboulis CC. Malignant atrophic papulosis (Köhlmeier-Degos disease) - a review. Orphanet J Rare Dis. 2013 Jan 14;8:10. doi: 10.1186/1750-1172-8-10. PMID: 23316694; PMCID: PMC3566938.).
3- Reyns, Bradford W., Bonnie S. Fisher, and Ryan Randa. "Explaining cyberstalking victimization against college women using a multitheoretical approach: Self-control, opportunity, and control balance." Crime & Delinquency 64.13 (2018): 1742-1764.
4- Kumar, Jothi Vinoth, et al. "Construction of SnO2/g-C3N4 an effective nanocomposite for photocatalytic degradation of amoxicillin and pharmaceutical effluent." Environmental Research 209 (2022): 112809.
5- Boo, Yong Chool. "Mechanistic basis and clinical evidence for the applications of nicotinamide (niacinamide) to control skin aging and pigmentation." Antioxidants 10.8 (2021): 1315.
6- Gu, Yanpei, et al. "Biomarkers, oxidative stress and autophagy in skin aging." Ageing research reviews 59 (2020): 101036
7- Kammeyer, A., and R. M. Luiten. "Oxidation events and skin aging." Ageing research reviews 21 (2015): 16-29.
8-Fritz, Heidi, et al. "Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis." PloS one 6.6 (2011): e21107.
9-Kolli, Sree S., et al. "Topical retinoids in acne vulgaris: a systematic review." American Journal of Clinical Dermatology 20.3 (2019): 345-365.
10-Higdon, Jane, V. J. Drake, and B. Delage. "Vitamin A Linus Pauling Institute, Oregon State University." (2010).
11-Kulier, R., A. M. Gülmezoglu, and J. Villar. "Vitamin A supplementation during pregnancy." The Cochrane Database of Systematic Reviews 4 (2002): CD001996-CD001996.
12-Temova Rakuša, Žane, et al. "Retinoid stability and degradation kinetics in commercial cosmetic products." Journal of cosmetic dermatology 20.7 (2021): 2350-2358.
13-Temova Rakuša, Žane, et al. "Quality control of retinoids in commercial cosmetic products." Journal of Cosmetic Dermatology 20.4 (2021): 1166-1175.
14-Chandraratna, R. A. S. "Tazarotene—first of a new generation of receptor‐selective retinoids." British Journal of Dermatology 135 (1996): 18-25.
15-Chandraratna, R. A. S. "Future trends: a new generation of retinoids." Journal of the American Academy of Dermatology 39.4 (1998): S149-S152.
16-Schapira, Matthieu, et al. "Rational discovery of novel nuclear hormone receptor antagonists." Proceedings of the National Academy of Sciences 97.3 (2000): 1008-1013.
17- Krutmann, Jean, et al. "Environmentally-induced (extrinsic) skin aging: Exposomal factors and underlying mechanisms." Journal of Investigative Dermatology 141.4 (2021): 1096-1103.
18- Tigges, J., Krutmann, J., Fritsche, E., Haendeler, J., Schaal, H., Fischer, J. W., ... & Boege, F. (2014). The hallmarks of fibroblast ageing. Mechanisms of ageing and development, 138, 26-44.
19- Gu, Yanpei, et al. "Biomarkers, oxidative stress and autophagy in skin aging." Ageing research reviews 59 (2020): 101036.
20- Cai, Liqi, et al. "Characteristic of microplastics in the atmospheric fallout from Dongguan city, China: preliminary research and first evidence." Environmental Science and Pollution Research 24.32 (2017): 24928-24935.
21- Vierkötter, Andrea, et al. "Airborne particle exposure and extrinsic skin aging." Journal of investigative dermatology 130.12 (2010): 2719-2726.
22- Kebriaei, Partow, et al. "Phase I trials using Sleeping Beauty to generate CD19-specific CAR T cells." The Journal of clinical investigation 126.9 (2016): 3363-3376.
23- Dattler, Damien, et al. "Design of collective motions from synthetic molecular switches, rotors, and motors." Chemical reviews 120.1 (2019): 310-433.
24- F. Flament, R. Bazin, H. Qiu, C. Ye, S. Laquieze, V. Rubert, et al.Solar exposure(s) and facial clinical signs of aging in Chinese women: impacts upon age perception Clin Cosmet Investig Dermatol, 8 (2015), pp. 75-84
25- Pilkington, Suzanne M., et al. "Inflammaging and the Skin." Journal of Investigative Dermatology 141.4 (2021): 1087-1095
26- Deng, Sophie X., et al. "Global consensus on the definition, classification, diagnosis and staging of limbal stem cell deficiency." Cornea 38.3 (2019): 364.
27- M.R. Iannacone, M.C. Hughes, A.C. Green Effects of sunscreen on skin cancer and photoaging Photodermatol Photoimmunol Photomed, 30 (2014), pp. 55-61
28- J. Krutmann, B.A. Gilchrest Photoaging of skin B.A. Gilchrest, J. Krutmann (Eds.), Skin aging, Springer, Heidelberg (2006), pp. 33-43
29- Krutmann, Jean, et al. "The skin aging exposome." Journal of dermatological science 85.3 (2017): 152-161.).
30- Aizen, Efraim, and Amos Gilhar. "Smoking effect on skin wrinkling in the aged population." International journal of dermatology 40.7 (2001): 431-433.
31- Reilly, David M., and Jennifer Lozano. "Skin collagen through the lifestages: Importance for skin health and beauty." Plastic and Aesthetic Research 8 (2021): 2.
32- Carazo, Alejandro, et al. "Vitamin A update: Forms, sources, kinetics, detection, function, deficiency, therapeutic use and toxicity." Nutrients 13.5 (2021): 1703.
33- Rusu, Aura, et al. "Recent advances regarding the therapeutic potential of adapalene." Pharmaceuticals 13.9 (2020): 217.
34- Zasada, Malwina, and Elżbieta Budzisz. "Retinoids: Active molecules influencing skin structure formation in cosmetic and dermatological treatments." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 36.4 (2019): 392-397.
35- Rhinn, Muriel, and Pascal Dollé. "Retinoic acid signalling during development." Development 139.5 (2012): 843-858.
36- Wiesinger, Alexandra, et al. "Retinoic acid signaling in heart development: application in the differentiation of cardiovascular lineages from human pluripotent stem cells." Stem Cell Reports 16.11 (2021): 2589-2606.
37- Michalak, Monika, et al. "Bioactive compounds for skin health: A review." Nutrients 13.1 (2021): 203.
38- Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945–973.e33.
39- Leyden, James J. "The role of isotretinoin in the treatment of acne: personal observations." Journal of the American Academy of Dermatology 39.2 (1998): S45-S49.
40- Motamedi, Melika, et al. "A Clinician’s Guide to Topical Retinoids." Journal of Cutaneous Medicine and Surgery 26.1 (2022): 71-78.
41- Thielitz A., Abdel-Naser MB., Fluhr JW., Zouboulis CC., Gollnick H. Topical retinoids in acne - an evidence-based overview. J Dtsch Dermatol Ges. 2008;6(12):1023-1031
42- Lam, Kaitlyn, and Ronald Vender. "Mechanism of action of acitretin." Retinoids in Dermatology. CRC Press, 2019. 27-31.
43- Pearce DJ, Klinger S, Ziel KK, Murad EJ, Rowell R, Feldman SR. Low-dose acitretin is associated with fewer adverse events than high-dose acitretin in the treatment of psoriasis. Arch Dermatol. 2006 Aug;142(8):1000–4.
44- Woodley DT, Zelickson AS, Briggaman RA, et al. Treatment of photoaged skin with topical tretinoin increases epidermal-dermal anchoring fibrils. a preliminary report. JAMA. 1990;263:3057-3059.
45- Olsen EA, Katz I, Levine N, et al. Tretinoin emollient cream:
a new therapy for photodamaged skin. J Am Acad Dermatol.
1992;26:215-224.
46- Clinical effects of long-term therapy with topical tretinoin and cellular mode of action
47- Zhu, Shengqian, et al. "Protective Effect of Fat-Tissue–Derived Products against Ultraviolet Irradiation–Induced Photoaging in Mouse Skin." Plastic and Reconstructive Surgery 148.6 (2021): 1290-1299.
48- Reszko, Anetta E., Diane Berson, and Mary P. Lupo. "Cosmeceuticals: practical applications." Dermatologic clinics 27.4 (2009): 401-416.
49- Kang S, Duell EA, Fisher GJ, et al. Application of retinol to
human skin in vivo induces epidermal hyperplasia and cellular
retinoid binding proteins characteristic of retinoic acid but without measurable retinoic acid levels or irritation. J Invest Dermatol.
1995;105:549-556.
50- BOWES, LORNA. "Topical vitamin A: types and applications in aesthetic medicine." Journal of Aesthetic Nursing 8.3 (2019): 106-115.
51- Fields, Jaime R., et al. "Topical ketoconazole for the treatment of androgenetic alopecia: a systematic review." Dermatologic therapy 33.1 (2020): e13202.
52- Ferreira, Rafael M., et al. "Unravelling potential virulence factor candidates in Xanthomonas citri. subsp. citri by secretome analysis." PeerJ 4 (2016): e1734.
53- Roeder A, Schaller M, Schäfer-Korting M, Korting HC. Tazarotene: therapeutic strategies in the treatment of psoriasis, acne and photoaging. Skin Pharmacol Physiol. 2004 May-Jun;17(3):111-8. doi: 10.1159/000077236. PMID: 15087589.
54- Nagpal, Sunil, et al. "Tazarotene-induced gene 2 (TIG2), a novel retinoid-responsive gene in skin." Journal of Investigative Dermatology 109.1 (1997): 91-95.
55- DiSepio, Daniel, et al. "Identification and characterization of a retinoid-induced class II tumor suppressor/growth regulatory gene." Proceedings of the National Academy of Sciences 95.25 (1998): 14811-14815.
56- Williams, Amy Lavin, Nelson D. Pace, and John M. DeSesso. "Teratogen update: topical use and third‐generation retinoids." Birth defects research 112.15 (2020): 1105-1114.
57- Rusu, Aura, et al. "Recent advances regarding the therapeutic potential of adapalene." Pharmaceuticals 13.9 (2020): 217.
58- Tolaymat, Leila, Heidi Dearborn, and Patrick M. Zito. "Adapalene." StatPearls [Internet]. StatPearls Publishing, 2022.
59- Otlewska, Agnieszka, Wojciech Baran, and Aleksandra Batycka-Baran. "Adverse events related to topical drug treatments for acne vulgaris." Expert Opinion on Drug Safety 19.4 (2020): 513-521.
60- Leyden, Dennis P., and Matthias Menter. "The impact of knowledge transfer on innovation: exploring the cross-fertilization of basic and applied research." Handbook of Technology Transfer. Edward Elgar Publishing, 2022. 25-38.
61- Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327-48. doi: 10.2147/ciia.2006.1.4.327. PMID: 18046911; PMCID: PMC2699641.
62- Draelos ZD. Novel approach to the treatment of hyperpigmented photodamaged skin: 4% hydroquinone/0.3% retinol versus tretinoin 0.05% emollient cream. Dermatol Surg. 2005;31:799-804.
63- Draelos Z, Lewis J, McHugh L, Pellegrino A, Popescu L. Novel retinoid ester in combination with salicylic acid for the treatment of acne. J Cosmet Dermatol. 2016 Mar;15(1):36-42. doi: 10.1111/jocd.12190. Epub 2015 Oct 30. PMID: 26516077.
64- Ruamrak, C., N. Lourith, and S. Natakankitkul. "Comparison of clinical efficacies of sodium ascorbyl phosphate, retinol and their combination in acne treatment." International journal of cosmetic science 31.1 (2009): 41-46.
65- Pfannschmidt N, Bauer R, Kreysel HW. [Combined topical treatment of acne with erythromycin and tretinoin]. Zeitschrift fur Hautkrankheiten. 1988 May;63(5):366-8, 373. PMID: 2970158.
66- Ramachandran, Vignesh, et al. "Treating psoriasis with halobetasol propionate and tazarotene combination: a review of phase II and III clinical trials." Annals of Pharmacotherapy 54.9 (2020): 872-878.
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An overview about Therapeutic uses, clinical efficacy, safety and classes of Retinoids and its efficacy for Treatment of skin aging . (2023). University of Thi-Qar Journal of Science, 10(1). https://doi.org/10.32792/utq/utjsci/v10i1.914
