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Previous Volume 329:530-535 August 19, 1993 Number 8 Next

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ABSTRACT

Background Topical tretinoin (retinoic acid) modifies fine wrinkles and certain other features of human skin damaged by exposure to the sun (photodamage), but histologic changes do not account for this improvement. In mice with photodamage induced by ultraviolet light, effacement of fine wrinkles by tretinoin is correlated with dermal collagen synthesis but not with histologic changes. We investigated whether collagen synthesis was reduced in photodamaged human skin and, if so, whether it could be restored by treatment with topical tretinoin.

Methods Biopsies of photodamaged skin from the extensor aspect of the forearm and skin from the buttocks, which had been protected from the sun, were performed on 26 healthy subjects. In addition, 29 patients with photodamaged skin were treated for 10 to 12 months with a daily application of 0.1 percent tretinoin cream (15 patients) or vehicle cream (14 patients). Skin-biopsy specimens obtained at base line and after treatment were assessed immunohistologically for evidence of dermal collagen I formation (collagen synthesis).

Results Collagen I formation was 56 percent less in the papillary dermis of photodamaged skin than in skin protected from the sun (P<0.001) and was correlated with the clinical severity of photodamage (r = -0.58, P = 0.002). Treatment of photodamaged skin with tretinoin produced an 80 percent increase in collagen I formation, as compared with a 14 percent decrease in collagen formation with the use of vehicle alone (P = 0.006).

Conclusions The formation of collagen I is significantly decreased in photodamaged human skin, and this process is partly restored by treatment with tretinoin.

Source Information

From the Dermatopharmacology Unit, Department of Dermatology, University of Michigan Medical Center, Ann Arbor. Presented in part at the annual meeting of the Society for Investigative Dermatology, Washington, D.C., April 28-30, 1993.

Address reprint requests to Dr. Voorhees at the Department of Dermatology, University of Michigan Medical Center, 1910 Taubman Ctr., 1500 E. Medical Ctr. Dr., Ann Arbor, MI 48109-0314.

Full Text of this Article

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Effect of Tretinoin on Collagen Formation in Photodamaged Skin
Whitmore S. E., Krupsky M., Goldstein R. H., Griffiths C. E.M., Hamilton T. A., Voorhees J. J.
Extract | Full Text  
N Engl J Med 1993; 329:2038-2039, Dec 30, 1993. Correspondence

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