title: Histologic improvement in photodamage after 12 months of treatment with tretinoin emollient cream (0.02%).
abstract: OBJECTIVE
  Topical retinoids, such as tretinoin, have been established as the gold standard for the treatment of photodamaged skin. This was a single-center, open-label, single-group, observational histologic subanalysis of 3 of 19 patients participating in a study of the efficacy and safety of tretinoin emollient cream 0.02% for the treatment of moderate to severe facial photodamage.
  
  
  METHODS
  Subjects were female, 18 years of age or older, and instructed to apply tretinoin 0.02% to the treatment areas for 12 months. Histology was undertaken using facial photographs and 2-mm biopsies of the lateral canthus area that were obtained from 3 subjects at baseline and 12 months.
  
  
  RESULTS
  Histopathologic analyses revealed evidence of extensive solar elastosis at baseline for 2 of the 3 subjects who were white, with moderate elastosis observed for the third subject who was African American. Histologic improvements in photodamage following 12 months of treatment with tretinoin 0.02% were observed for each subject. Improvements included smoothing of the epidermis, a slightly thinner keratin layer, and thin, comparatively straight elastic and collagen fibers in the mid- to deep-dermal layer.
  
  
  CONCLUSIONS
  The histologic changes in all subjects could be attributed to a remodeling (elastin) or repair (collagen) process that affected the connective tissue fibers in all layers of the dermis. These results suggest that tretinoin 0.02% may be an effective treatment for photodamage, and additional evaluation is warranted in future studies.
authors.affiliation: Physicians Skin Care, PLLC, Louisville, KY 40217, USA. wedoderm@yahoo.com
authors.forename: Leon H
authors.initials: LH
authors.lastname: Kircik
mesh_terms: D000279:Administration, Cutaneous; D003094:Collagen / Q000378:metabolism; D004549:Elastin / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007633:Keratins / Q000378:metabolism; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D015595:Skin Aging / Q000187:drug effects* / Q000473:pathology; D013472:Sunlight / Q000009:adverse effects; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014466:Ultraviolet Rays / Q000009:adverse effects*
chemical_list: D007641:Keratolytic Agents; D014212:Tretinoin; D007633:Keratins; D003094:Collagen; D004549:Elastin