A review of acitretin for the treatment of psoriasis.
BACKGROUND
Acitretin is an oral retinoid that is approved for the treatment of psoriasis. It is unique compared to other systemic therapies for psoriasis such as methotrexate and cyclosporine in that it is not immunosuppressive. It is, therefore, safe for use in psoriasis patients with a history of chronic infection such as HIV, hepatitis B, hepatitis C or malignancy who have a contraindication to systemic immunosuppressive therapy and require systemic therapy because topical therapy is inadequate and they are unable to commit to phototherapy. Acitretin is one of the treatments of choice for pustular psoriasis. Even though acitretin is less effective as a monotherapy for chronic plaque psoriasis, combination therapy with other agents, especially UVB or psoralen plus UVA phototherapy, can enhance efficacy.


OBJECTIVE
To provide an updated review of the safety and efficacy of acitretin in the treatment for psoriasis.


METHODS
Literature review of journal articles from 2008 to 2009 since the last review of acitretin evaluated medical literature from 2005 to 2008.


CONCLUSIONS
Acitretin is an effective systemic therapy for psoriasis and is generally well tolerated at low doses for long-term use. If monotherapy with acitretin is inadequate, it can be used in combination with other treatments, particularly UVB phototherapy, to increase efficacy.
Lee
Chai Sue
CS
University of California Davis Medical Center, Department of Dermatology, Sacramento, 95816, USA. chaisue@yahoo.com
Li
Kai
K
D017255:Acitretin / Q000009:adverse effects* / Q000191:economics / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D006801:Humans; D007641:Keratolytic Agents / Q000009:adverse effects* / Q000191:economics / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000473:pathology
D007641:Keratolytic Agents; D017255:Acitretin