The role of tazarotene in the treatment of psoriasis

The recent availability of tazarotene, the first receptor-selective retinoid, provides a much-needed addition to the therapeutic armamentarium for mild-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 β and γ subtypes of retinoic acid receptors suggests a targeted action on psoriatic keratinocytes, which may help to minimize the risk of adverse effects. The potential for adverse effects is further minimized by the limited transcutaneous absorption of tazarotene, its rapid metabolism into hydrophilic metabolites, and its rapid elimination from the body. These pharmacokinetic features ensure that plasma levels of tazarotene and its main metabolite, tazarotenic acid, are minimized — thus limiting systemic exposure. The hydrophilicity of the metabolites also limits systemic exposure by ensuring that accumulation does not occur in lipophilic tissues.