The role of tazarotene in the treatment of psoriasis

The recent availability of tazarotene, the first receptor-selective retinoi d, provides a much-needed addition to the therapeutic armamentarium for mil d-to-moderate plaque psoriasis. Tazarotene gel offers a welcome combination of good efficacy and cosmetic acceptability, with minimal risk of systemic adverse effects. The selectivity of tazarotene for the beta and gamma subt ypes of retinoic acid receptors suggests a targeted action on psoriatic ker atinocytes, which may help to minimize the risk of adverse effects. The pot ential for adverse effects is further minimized by the limited transcutaneo us absorption of tazarotene, its rapid metabolism into hydrophilic metaboli tes. and its rapid elimination from the body. These pharmacokinetic feature s ensure that plasma levels of tazarotene and its main metabolite, tazarote nic acid, are minimized - thus limiting systemic exposure. The hydrophilici ty of the metabolites also limits systemic exposure by ensuring that accumu lation does not occur in lipophilic tissues.