Leukemia[edit]

Tretinoin is used to induce remission in people with acute promyelocytic leukemia who

have a mutation (the t(15;17) translocation 160 and/or the presence of the PML/RARα

gene) and who do not respond to anthracyclines or cannot take that class of drug. It is

not used for maintenance therapy.[3][19][20]

The evidence is very uncertain about the effect of tretinoin in addition to chemotherapy

for patients with an acute myeloid leukemia on diarrhoea, nausea/vomiting and heart-

related toxicity grades III/IV. Furthermore, tretinoin in addition to chemotherapy probably

results in little to no difference in the mortality, relapse, progress, mortality during the

trial and infections grade III/IV.[21]

Skin use[edit]

Topical tretinoin is only for use on the skin and should not be applied to eyes or

mucosal tissues. Common side effects include skin irritation, redness, swelling, and

blistering.[4] If irritation is a problem, a decrease in the frequency of application to every

other or every third night can be considered, and the frequency of application can be

increased as tolerance improves. The fine skin flaking that is often seen can be gently

exfoliated with a washcloth. A non-comedogenic facial moisturizer can also be applied if

needed. Delaying application of the retinoid for at least 20 minutes after washing and

drying the face may also be helpful. Topical retinoids are not true photosensitizing

drugs, but people using topical retinoids have described symptoms of increased sun

sensitivity. This is thought to be due to thinning of the stratum corneum leading to a

decreased barrier against ultraviolet light exposure, as well as an enhanced sensitivity

due to the presence of cutaneous irritation.[24]