Alitretinoin (Panretin) is a topical formulation of 9-cis-retinoicacid which is approved for the treatment of cutaneous lesions in patients with AIDS-related Kaposi’s sarcoma. Localized reactions may include intense erythema, edema, and vesiculation necessitat-ing discontinuation of therapy. Patients who are applying alitretin-oin should not concurrently use products containing DEET, a common component of insect repellant products.
Bexarotene (Targretin) is a member of a subclass of retinoidsthat selectively binds and activates retinoid X receptor subtypes. It is available both in an oral formulation and as a topical gel for the treatment of cutaneous T-cell lymphoma. Teratogenicity is a sig-nificant risk for both systemic and topical treatment with bexaro-tene, and women of childbearing potential must avoid becoming pregnant throughout therapy and for at least 1 month following discontinuation of the drug. Bexarotene may increase levels of triglycerides and cholesterol; therefore, lipid levels must be moni-tored during treatment.
Vorinostat (Zolinza) and romidepsin (Istodax) are histonedeacetylase inhibitors that are approved for the treatment of cuta-neous T-cell lymphoma in patients with progressive, persistent, or recurrent disease after prior systemic therapy. Adverse effects include thrombocytopenia, anemia, and gastrointestinal distur-bances. Pulmonary embolism, which has occurred with vorino-stat, has not been reported to date with romidepsin.