Clinical and ultrastructural effects of acitretin in Darier's disease.
Thirteen patients with Darier's disease with a mean extent of the lesions of 29.4 +/- 10% of the total skin area were treated with acitretin (the main metabolite of etretinate) for 16 weeks. The dose was 30 mg/day during the initial 8 weeks and was later adjusted individually to 10-30 mg/day in order to achieve optimal results. Three patients cleared completely, 7 patients showed marked improvement and 3 patients became slightly better during treatment. The mean extent of the lesions after the treatment was 7.3 +/- 8% of the skin area. Despite good clinical clearing, the improvement at the ultrastructural level was incomplete in the 3 patients studied by electron microscopy. Normal stratification did not develop and the size and number of desmosomes remained reduced. The main side effects during treatment were pruritus in 5 patients, diffuse alopecia in 2 patients and marked elevation in serum triglycerides in 4 patients. On the basis of this study, acitretin would seem to be a useful alternative to etretinate for the treatment of Darier's disease.
Lauharanta
J
J
Department of Dermatology, University Central Hospital, Helsinki, Finland.
Kanerva
L
L
Turjanmaa
K
K
Geiger
J M
JM
D017255:Acitretin; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D007644:Darier Disease / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D004817:Epidermis / Q000378:metabolism / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007633:Keratins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D014212:Tretinoin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D014212:Tretinoin; D007633:Keratins; D017255:Acitretin