13cisretinoic

13cisretinoic, also known as isotretinoin or 13-cis-retinoic acid, is a synthetic retinoid and a derivative of vitamin A. It is the 13-cis isomer of all-trans retinoic acid (ATRA) and has the chemical formula C20H28O2. It is used medically for its strong effects on the skin and its ability to influence cell differentiation.

Isotretinoin works by modulating gene expression through binding to retinoic acid receptors (RARs) and retinoid X receptors (RXRs). This leads to decreased size and activity of sebaceous glands, reduced sebum production, and anti-inflammatory effects. It also influences keratinization, which can help normalize follicular turnover in acne.

Medical uses include treatment of severe nodular acne that has not responded to other therapies. In certain cancers, isotretinoin has been used as a differentiation agent, notably as part of maintenance therapy for high-risk neuroblastoma following aggressive treatment.

Administration is oral and typically given for several months. Isotretinoin is highly teratogenic, and it is contraindicated in pregnancy. Women of childbearing potential must participate in a pregnancy prevention program and use two forms of contraception. Safety monitoring includes baseline and periodic liver function tests and lipid panels. Common adverse effects are mucocutaneous dryness, cheilitis, and nosebleeds; less common but serious risks include mood changes, hyperlipidemia, and hepatic injury.

Isotretinoin is available in generic form and has a long-standing role in dermatology, with additional niche uses in oncology.