Abstract

A particular uncommon isomer of retinoic acid (namely 11-cis-retinoic acid, or neotretinoin) is useful in treating conditions involving abnormal cellular differentiation and hyperproliferation, such as psoriasis. A new method of synthesizing this isomer, in quantities that has allowed it to be compared therapeutically with the more commonly available all-trans and 13-cis isomers, is presented. As measured on the inventor's own psoriasis-affected skin, topical treatment with 11-cis-retinoic acid is much more efficacious in reducing symptoms and has substantially reduced side effects, as compared to topical treatment with the other isomers. A single application of a 0.001% neotretinoin cream to psoriasis lesions leads within 48 hours to substantial amelioration of associated dermatological symptoms, including itching, scaling, bleeding, and abnormal appearance. Continued application leads to complete remission, and replacement of lesions by skin that is indistinguishable from surrounding healthy tissue, without any noticeable irritation, erythema, or other problematic side effects. A less efficacious but more easily-implemented version of the same invention employs ultraviolet or blue-light irradiation of a commercially-available gel containing tretinoin as a means of effecting partial conversion of the tretinoin to neotretinoin, prior to application of the gel to psoriasis-affected areas of skin.