title: Intra-epidermal accumulation of polymorphonuclear leukocytes in persistent palmoplantar pustulosis during treatment with acitretin.
abstract: Six patients with persistent palmoplantar pustulosis were treated with acitretin, and the clinical response was compared with the effect on the intra-epidermal accumulation of polymorphonuclear PMN leukocytes. A prompt improvement of pustule formation and subsequently decreased scaling and erythema was seen in all patients. Following discontinuation of therapy, a relapse occurred within 2 weeks. With dosages of 45 or 55 mg/day, the clinical scores were only slightly better than with 25 or 35 mg/day. In patients using 25 mg acitretin a day, the leukotriene B4-induced intra-epidermal accumulation of polymorphonuclear leukocytes was not affected. However, a dosage of 35 mg/day resulted in a significant inhibition of PMN accumulation, dosages of 45 and 55 mg/day causing an even more pronounced inhibition of this process. Although the effect of different dosages of acitretin is not clearly expressed in the severity scores, the dose-dependent effect on PMN chemotaxis in vivo might be of relevance when combination therapies are considered, in order to achieve a complete clinical clearance.
authors: Department of Dermatology, University of Nijmegen, The Netherlands.
authors: P C
authors: PC
authors: van de Kerkhof
authors: A
authors: A
authors: Chang
authors: R
authors: R
authors: van Dooren-Greebe
authors: J M
authors: JM
authors: Geiger
authors: R
authors: R
authors: Happle
mesh_terms: D017255:Acitretin; D000328:Adult; D002634:Chemotaxis, Leukocyte / Q000187:drug effects*; D002986:Clinical Trials as Topic; D004361:Drug Tolerance; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000503:physiopathology; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology; D011565:Psoriasis / Q000188:drug therapy; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy* / Q000503:physiopathology; D014212:Tretinoin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D014212:Tretinoin; D017255:Acitretin