Retinol palmitate: potential applications in combination therapy of patients with chronic eczema

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

BACKGROUND: The chronic stage of eczema is characterized by marked impairment of the skin barrier function, necessitating prolonged multimodal therapy. In cases of pronounced infiltration, lichenification, and resistance to standard treatment, positive effects of incorporating retinoids into therapeutic regimens for this condition have been reported.

AIM: The work aimed to evaluate the efficacy and safety of oral oily retinol palmitate solution as part of combination therapy in patients with chronic eczema.

METHODS: The study included 60 patients with mild-to-moderate chronic eczema who were divided into two groups of 30 patients each (main group and comparison group) according to the treatment received. Therapy in both groups comprised topical calcineurin inhibitors, zinc pyrithione, 10% naftalan oil liniment, and an emollient containing 10% urea. Patients in the main group additionally received oral retinol palmitate solution. Treatment efficacy was assessed based on changes in the Eczema Area and Severity Index (EASI), the Dermatology Life Quality Index (DLQI), and the number of disease exacerbations recorded before treatment and on days 30, 60, and 90 of therapy.

RESULTS: By day 30 of treatment, patients in both groups demonstrated significant improvement in skin manifestations (p ≤0.05). However, symptom regression was more pronounced in the main group, where EASI scores decreased by 77.0%, compared with a 58.1% reduction in the comparison group (p ≤0.05). The marked clinical improvement was accompanied by a reduction in disease-related quality-of-life impairment: DLQI scores decreased by 53.1% in the main group and by 39.4% in the comparison group (p ≤0.05). During subsequent follow-up, the positive trends of disease symptoms persisted, although no significant differences between the groups were observed.

CONCLUSION: The addition of oral oily retinol palmitate solution to combination therapy for patients with chronic eczema is associated with accelerated regression of clinical symptoms and improved quality of life. At the same time, topical therapy including calcineurin inhibitors, zinc pyrithione, 10% naftalan oil liniment, and an emollient containing 10% urea demonstrates sustained efficacy throughout the treatment course.

Full Text

Restricted Access

About the authors

Marina M. Tlish

Kuban State Medical University

Email: tlish_mm@mail.ru
ORCID iD: 0000-0001-9323-4604
SPIN-code: 8452-4062

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Krasnodar

Marina E. Shavilova

Kuban State Medical University

Email: nzhannau@mail.ru
ORCID iD: 0000-0002-5776-6221
SPIN-code: 3346-6060

MD, Cand. Sci. (Medicine)

Russian Federation, Krasnodar

Taisiya G. Kuznetsova

Kuban State Medical University

Email: nzhannau@mail.ru
ORCID iD: 0000-0002-0426-5167
SPIN-code: 1315-2363

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Krasnodar

Zhanna Y. Naatyzh

Kuban State Medical University

Email: taya1504@mail.ru
ORCID iD: 0000-0001-9754-5063
SPIN-code: 3680-1603

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Krasnodar

Stanislava Y. Petrova

Retinoids; I. Mechnikov Research Institute of Vaccines and Sera

Author for correspondence.
Email: petrova.s@retinoids.ru
ORCID iD: 0000-0003-3034-0148
SPIN-code: 7268-6944

MD, Cand. Sci. (Medicine)

Russian Federation, Balashikha; Moscow

Konstantin V. Nozdrin

Retinoids

Email: kvn@retinoids.ru
ORCID iD: 0000-0002-2943-3585
SPIN-code: 9884-3751

Cand. Sci. (Pharmacy)

Russian Federation, Balashikha

References

  1. Rubricator of clinical recommendations of the Russian Ministry of Health [Internet]. Clinical recommendations. Eczema. Russian Society of Dermatovenerologists and Cosmetologists; 2024. (In Russ.) Available from: https://cr.minzdrav.gov.ru/view-cr/246_3 Accessed: 2026 Jan 15.
  2. Weidinger S, Novak N. Hand eczema. Lancet. 2024;404(10470):2476–2486. doi: 10.1016/S0140-6736(24)01810-5 EDN: HPCMUR
  3. Lazarev VV, Tlish MM, Shavilova ME. Skin and gut microbiome in patients with chronic microbial eczema: assessment using metagenomic sequencing and its dynamics during therapy. Lechebnoe delo. 2024;(2):75–83. doi: 10.24412/2071-5315-2024-13114 EDN: KAZQEN
  4. Tlish MM, Popandopulo EK. Dynamics of the antioxidant system and endogenous intoxication in patients being treated for microbial eczema. Kuban scientific medical bulletin. 2019;26(4):56–65. doi: 10.25207/1608-6228-2019-26-4-56-65 EDN: CYCCNE
  5. Skripkin YuK, Mordovtsev VN, editors. Skin and venereal diseases: a guide for doctors. In 2 vol. 2nd revised and updated. Moscow: Meditsina; 1999. (In Russ.)
  6. Tokura Y, Yunoki M, Kondo S, Otsuka M. What is “Eczema”? J Dermatol. 2025;52(2):192–203. doi: 10.1111/1346-8138.17439 EDN: MSXNVG
  7. Thyssen JP, Agner T, Schuttelaar ML, et al. Guidelines for diagnosis, prevention, and treatment of hand eczema. Contact Dermatitis. 2022;86(5):357–378. doi: 10.1111/cod.14035 EDN: LTZKVJ
  8. Voorberg AN, Loman L, Schuttelaar ML. Prevalence and severity of hand eczema in the Dutch general population: a cross-sectional, questionnaire study within the lifelines cohort study. Acta Derm Venereol. 2022;102:adv00626. doi: 10.2340/actadv.v101.432 EDN: XGPVIR
  9. Quaade AS, Alinaghi F, Dietz JB, et al. Chronic hand eczema: a prevalent disease in the general population associated with reduced quality of life and poor overall health measures. Contact Dermatitis. 2023;89(6):453–463. doi: 10.1111/cod.14407 EDN: MRJPXF
  10. Tlish MM, Shavilova ME, Psavok FA. Microbial eczema: modern possibilities of consistent topical therapy. Medical council. 2023;17(23):322–327. doi: 10.21518/ms2023-476 EDN: QBTHND
  11. Christoffers WA, Coenraads PJ, Svensson A, et al. Interventions for hand eczema. Cochrane Database Syst Rev. 2019;4(4):CD004055. doi: 10.1002/14651858.CD004055.pub2
  12. Fukue T, Nombra I, Horimukay K, et al. Proactive treatment appears to decrease serum immunoglobulin-E levels in patients with severe atopic dermatitis. Br J Dermatol. 2010;163(5):1127–1129. doi: 10.1111/j.1365-2133.2010.09904.x
  13. Weisshaar E. Chronic hand eczema. Am J Clin Dermatol. 2024;25(6):909–926. doi: 10.1007/s40257-024-00890-z EDN: YHISZB
  14. Vaskova J, Stupak M, Vidová Ugurbaş M, et al. The rapeutic uses of retinol and retinoid-related antioxidants. Molecules. 2025;30(10):2191. doi: 10.3390/molecules30102191 EDN: PQFWZI
  15. Kwon HI, Kim JE, Ko JY, Ro YS. Efficacy and safety of alitretinoin for chronic hand eczema in Korean patients. Ann Dermatol. 2016;28(3):364–370. doi: 10.5021/ad.2016.28.3.364
  16. Gola M, Milanesi N, D’Erme AM. Clinical evaluation and assessment of the therapeutic efficacy of alitretinoin in a group of patients with chronic hand eczema refractory to topical steroid therapy. G Ital Dermatol Venereol. 2014;149(4):435–439.
  17. Ham K, Maini P, Gooderham MJ. Real-world experience with alitretinoin in a community dermatology practice setting in patients with chronic hand dermatitis. J Cutan Med Surg. 2014;18(5):332–336. doi: 10.2310/7750.2014.13195
  18. Rousselle C. Opinion of the scientific committee on consumer safety (SCCS): final version of the opinion on vitamin A (retinol, retinyl acetate and retinyl palmitate) in cosmetic products. Regul Toxicol Pharmacol. 2017;84:102–104. doi: 10.1016/j.yrtph.2016.11.017
  19. Nozdrin KV, Kokolina VF, Kartelishchev AV, et al. Technologies of systemic retinotherapy in pediatric practice: methodological recommendations. Rumyantsev AG, editor. Moscow: Retinoidy; 2016. 43 p. (In Russ.) ISBN 978-5-93118-051-9
  20. Petrova SYu, Albanova VI, Nozdrin KV, Guzev KS. Main effects of retinol palmitate on skin structures and the technology of its use in dermatological practice. Vestnik dermatologii i venerologii. 2023;99(1):6–17. doi: 10.25208/vdv1375 EDN: PRWAVQ
  21. Melnik BC. Acne transcriptomics: fundamentals of acne pathogenesis and isotretinoin treatment. Cells. 2023;12(22):2600. doi: 10.3390/cells12222600
  22. Schug TT, Berry DC, Shaw NS, et al. Opposing effects of retinoic acid on cell growth result from alternate activation of two different nuclear receptors. Cell. 2007;129(4):723–733. doi: 10.1016/j.cell.2007.02.050
  23. Hanifin JM, Baghoomian W, Grinich E, et al. The Eczema Area and Severity Index: a practical guide. Dermatitis. 2022;33(3):187–192. doi: 10.1097/DER.0000000000000895 EDN: BNUYQS
  24. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI): a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210–216. doi: 10.1111/j.1365-2230.1994.tb01167.x
  25. Glants S. Primer of biostatistics. New York: McGRAW-HILL; 1999.
  26. Nozdrin VI, Belousova TA, Albanova VI, Lavrik OI. Histopharmacological studies of the skin (our experience). Moscow: Retinoidy; 2006. 376 p. (In Russ.) EDN: QKORLV
  27. Nikolay N. Murashkin NN, Ivanov RA, et al. Substantiation of using pimecrolimus 1% cream in proactive therapy of children with atopic dermatitis. Curr Pediatr. 2021;20(5):376–382. doi: 10.15690/vsp.v20i5.2310 EDN: BPOXKT

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Impact of the disease on patients’ quality of life during therapy in the main study group according to DLQI trends: *, values differ significantly from those of the comparison group at the same observation time point (p ≤0.05). Pearson’s chi-square test and Fisher’s exact test were used.

Download (274KB)
Indexing metadata
3. Fig. 2 Patient Z., 59 years old. Clinical manifestations of idiopathic eczema at hospital admission (a) and at discharge and inclusion in the study (b): a reduction in the intensity of acute inflammatory reaction, epithelialization of individual fissures, with persistent infiltration and lichenification after discharge (EASI score: 4.4).

Download (760KB)
Indexing metadata
4. Fig. 3. Patient Z., 59 years old. Follow-up at day 30 (a), day 60 (b), and day 90 (c, d): positive trends of the skin manifestations were recorded. By day 30, erythema and infiltration had almost completely regressed (EASI score: 2.4); by day 60, fissures were fully epithelialized (EASI score: 0.4); by day 90, complete resolution of the skin process was observed.

Download (1MB)
Indexing metadata
5. Fig. 4. Patient V., 50 years old. Clinical manifestations of idiopathic eczema on the palmar surface of the hands before therapy initiation (a) and on day 30 of follow-up (b). At baseline, the skin lesions were mildly hyperemic with infiltration of varying intensity; alternating areas of affected and unaffected skin were observed on both hands; small fissures, excoriations, and scaling were present; isolated vesicles were noted on the lateral surfaces of the fingers (EASI score: 3.2). By day 30, hyperemia had resolved, with residual scaling, infiltration, and moderate lichenification (EASI score: 1.2).

Download (937KB)
Indexing metadata
6. Fig. 5. Patient V., 50 years old. Clinical manifestations of idiopathic eczema on the dorsal surface of the hands before therapy initiation (a) and on day 60 of follow-up (b); lateral view of the left index finger on day 90 (c). At baseline, the skin lesions were mildly hyperemic with infiltration and scaling of varying intensity; isolated microvesicles were present on the lateral surfaces of the fingers (EASI score: 3.2). By day 60, infiltration regressed and microvesicles disappeared (EASI score: 0.4); by day 90, complete resolution of the skin process was observed. Minimal residual scaling remained.

Download (1MB)
Indexing metadata
7. Fig. 6. Patient V., 50 years old. Palmar surface of the hands on day 60 (a) and day 90 (b) of follow-up: by day 60, infiltration had regressed (EASI score: 0.4); by day 90 (left hand), complete resolution of the skin process was observed.

Download (1MB)
Indexing metadata

Copyright (c) 2026 Eco-Vector

License URL: https://eco-vector.com/for_authors.php#07
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 86501 от 11.12.2023 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80653 от 15.03.2021 г.