Alitretinoin, or 9-cis-retinoic acid, is a form of vitamin A. It is also used in medicine as an antineoplastic (anti-cancer) agent developed by Ligand Pharmaceuticals. It is a first generation retinoid. Ligand gained Food and Drug Administration (FDA) approval for alitretinoin in February 1999. Medical uses
Kaposi’s sarcoma
In the United States, topical alitretinoin is indicated for the treatment of skin lesions in AIDS-related Kaposis sarcoma. Alitretinoin is not indicated when systemic therapy against Kaposis sarcoma is required. It has received EMA (11 October 2000) and FDA (2 March 1999) approval for this indication. Chronic hand eczema
Alitretinoin has been granted prescription rights in the UK (08/09/2008) for in chronic hand eczema as used by mouth. In May 2009 the National Institute for Health and Clinical Excellence (NICE) issued preliminary guidance on the use of alitretinoin for the treatment of severe chronic hand eczema in adults. The recommendation stated that only patients with severe chronic hand eczema who are unresponsive to potent topical corticosteroids, oral immunosuppressants or phototherapy should receive the drug. Final NICE guidance is expected in August 2009. Adverse effects
Systemic use
Very common (>10% frequency):

Headache
Hypertriglyceridemia
High density lipoprotein decreased
HypercholesterolemiaCommon (1-10% frequency):

Uncommon (0.1-1% frequency):

Rare (<0.1% frequency):

Benign intracranial hypertension
VasculitisUnknown frequency:

Topical use
Very common (>10% frequency):

Rash (77%)
Pain (34%)
Itchiness (11%)Common (1-10% frequency):

Exfoliative dermatitis
Oedema
Skin changes
Paraesthesia

Contraindications
Pregnancy is an absolute contraindication as with most other vitamin A products, it should also be avoided when it comes to systemic use in any women that is of childbearing potential and not taking precautions to prevent pregnancy. Toctino (the oral capsule formulation of alitretinoin) contains soya oil and sorbitol.
Tubulocystic renal cell carcinoma is rare subtype of renal cell carcinoma. == References ==