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Treatment of Acne Vulgaris and Senile Keratoses with Vitamin A: Results of a Clinical Experiment

1950; Elsevier BV; Volume: 14; Issue: 4 Linguagem: Inglês

10.1038/jid.1950.35

1523-1747

Leonard E. Savitt, Maximilian E. Obermayer,

Skin and Cellular Biology Research

Recent advances in our knowledge of the relationship between vitamin A and cutaneous disorders are numerous but not spectacular. While a number of new dermatoses have been added to the list of those which appear to respond at least occasionally to the administration of vitamin A, such as leukoplakia vulvae (1), porokeratosis Mibelli (2), keratosis blennorrhagica (3), acrokeratosis verruciformis (4), pili torti (5), and hyperkatosis follicularis et parafollicularis in cutem penetrans (6), studies of the working mechanism of the substance have not been particularly successful. It was determined by chemical assay (7) that there is little evidence to show that dermatologic conditions influence or are influenced by the amount of vitamin A in the blood plasma. On the other hand, determination of the level of the vitamin in the blood serum of 8 normal persons and 11 patients with dermatologic disease following the administration of massive doses showed abnormally flat curves in patients with keratosis foilicularis, congenital dyskeratosis and infantile eczema (8). The response to the dark-adaptation test of patients with various dermatoses was reported not to differ significantly from that of persons with normal skins (9). It is likely that the advent of the aqueous preparations of the vitamin will facilitate bio-chemical studies; early reports (10) indicate their greater ability to raise the vitamin A level of the blood serum. We have been concerned for several years with the effect of the vitamin on the pathologic changes of the pilo-sebaceous follicle in acne vulgaris (11), a subject on which other investigators have recently reported their observations (12, 13). Since we were unable to arrive at definite conclusions about the efficacy of the therapy we decided to conduct a controlled clinical experiment which might yield more accurate data. After the experiment was well under way we read with interest the report of an exceptionally well-controlled and conducted experiment on the effect of vitamin A therapy on keratoses (14). The importance of a practical method for the control of precancerous lesions of the keratosis type was the reason for the second study.