Table 1.

Clinical questions identified by work group members

Retinoid Effects on Skin

What disorders of cornification/types of ichthyosis have been shown to benefit from use of retinoids? Are there types of ichthyosis for which retinoids might not be indicated?

Systemic Retinoid Dosing

What is the optimal dosing and duration of therapy? Is there a benefit to intermittent therapy? What are the indications for starting systemic retinoids? What considerations are there when choosing a systemic retinoid? Are there any side effects on skin?

Topical Retinoid Use

What are the indications for starting topical retinoids in ichthyosis/DOC? Are there differences in mechanism of action, efficacy, and side effects of various topical retinoids used in disorders of cornification? When is a child with ichthyosis/DOC at risk of substantial systemic absorption of a topical retinoid? Has topical retinoid absorption been shown to be of clinical concern? Is any monitoring required when using topical retinoids in ichthyosis/DOC?

Retinoid Effects on Bone

What are the clinical considerations and consequences of long‐term systemic retinoid use on bone health? What bone specific monitoring is recommended with the use of systemic retinoids for ichthyosis and disorders of cornification?

Systemic Retinoid Effects on the Eye

What are the clinical considerations and consequences of long‐term systemic retinoid use on eye health? What eye specific monitoring is recommended with the use of systemic retinoids for ichthyosis and disorders of cornification?

Systemic Retinoid Effects on Lipids and Liver

What are the clinical considerations and consequences of long‐term systemic retinoid use on the liver and lipid metabolism? What lipid and liver specific monitoring is recommended with the use of systemic retinoids for ichthyosis?

Psychiatric Effects of Systemic Retinoid Therapy

What are the psychiatric considerations and consequences of long‐term, systemic retinoid use? What psychiatric monitoring is recommended for patients with ichthyosis on long‐term systemic retinoid therapy?

Contraception Considerations of Long‐Term Systemic Retinoid Use

What are the contraceptive considerations for the long‐term use of systemic retinoids? What are the long‐term health consequences of combined contraceptive and systemic retinoid therapy? What are the contraceptive considerations for the long‐term use of systemic retinoids?

The Impact of iPLEDGE

What are iPLEDGE considerations and requirements when using long‐term systemic isotretinoin in patients with ichthyosis? Does the iPLEDGE program result in any barriers to care for patients with ichthyosis?