ABSTRACT

This chapter focuses on the side effects of retinoids, primarily in the cardiologic, otolaryngorhinologic, genitourinary, renal, and immunologic systems. The most common side effects associated with topical retinoids are skin reactions, with systemic side effects being quite rare. Isotretinoin is the most commonly used agent, and so it is responsible for most of the reported systemic side effects. Retinoids are involved in the signaling pathways affecting embryonic development. The use of isotretinoin during pregnancy may cause many developmental defects, including defects of the cardiovascular system; however, the cellular and molecular mechanisms of the developmental toxicity of isotretinoin are unclear. The pulmonary side effects associated with retinoids other than oral isotretinoin are quite limited. Oral isotretinoin increased hearing level at all audiometric frequencies. The teratogenic effects resulting from oral administration of isotretinoin, known as the retinoic acid syndrome, are characterized by craniofacial dysmorphism and neural tube defects.