Acitretin for Psoriasis Treatment

Title: A review of acitretin, a systemic retinoid for the treatment of psoriasis.
: Lee CS and Koo J.
Publication: Expert Opin Pharmacother. 2005 Aug;6(10):1725-34.

Acitretin is a second-generation, systemic retinoid treatment approved for psoriasis since 1997, and is considered the treatment of choice for pustular and erythrodermic psoriasis.

However, acitretin is less effective by itself for plaque psoriasis, although it is often used in combination with ultraviolet B light therapy or psoralen plus ultraviolet A light therapy. These combination therapies may potentially minimize toxicity lowering the dose of both drug and ultraviolet radiation.

All systemic retinoid are potential teratogens (chemicals that cause malformation of embryo or fetus). Side effects of acitretin are dosage dependent. The most common of these are:

  • Cheilitis (inflammation of the lips)
  • Hair loss

Acitretin does not suppress the immune system, and is generally safe for long-term use without any time limit restriction. This makes this drug very useful in combination therapy and for maintenance therapy.

Editor’s Note: systemic medicine is a medicine that affects the entire body (as compared to local or topical medicines). Retinoid is a chemical as well as natural derivative of vitamin A.

Pustular psoriasis is a rare and severe form of the disease, where painful small, pus-filled lesions are present usually in the palms of the hand and soles of the feet. Erythrodermic psoriasis is marked with erythema or redness, as well as flaking and thickened skin that cover the trunk of the body.

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