title: Acitretin in dermatology: a review.
abstract: BACKGROUND
  Acitretin is a systemic retinoid drug used in the treatment of severe psoriasis. It has also been used for a spectrum of other difficult-to-treat dermatoses, including hyperkeratotic and inflammatory dermatoses and non-melanoma skin cancers. Here we review the available data regarding both FDA-approved and off-label uses of acitretin, clinically relevant adverse events, precautions and monitoring.
  
  
  METHODS
  A PubMed literature search was conducted utilizing the search term "acitretin," which yielded 714 hits. Results were further limited to English language clinical trials in human subjects. Of 78 articles evaluated for relevance, 60 were included for review.
  
  
  RESULTS
  Acitretin is effective as monotherapy and in multidrug therapeutic regimens for the treatment of psoriasis and other hyperkeratotic and inflammatory disorders, as well as for malignancy chemoprevention. Its use is limited by its teratogenic potential and other adverse effects, including mucocutaneous effects and hepatotoxicity. Potential adverse effects may be reduced or avoided by using lower doses of acitretin or in combination with other therapies.
  
  
  CONCLUSIONS
  The reviewed studies include many small trials and case reports of the use of acitretin for psoriasis. Studies of acitretin therapy for the treatment of other cutaneous disorders are limited.
  
  
  CONCLUSIONS
  Acitretin is a beneficial treatment for psoriasis, and should be considered when not contraindicated. Particularly when used in combination with ultraviolet (UV) phototherapy, is a safe and cost effective therapeutic strategy.
authors: Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1071, USA.
authors: Lauren K
authors: LK
authors: Dunn
authors: Laini R
authors: LR
authors: Gaar
authors: Brad A
authors: BA
authors: Yentzer
authors: Jenna L
authors: JL
authors: O'Neill
authors: Steven R
authors: SR
authors: Feldman
mesh_terms: D017255:Acitretin / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D007641:Keratolytic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D056687:Off-Label Use; D011565:Psoriasis / Q000188:drug therapy; D012871:Skin Diseases / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000517:prevention & control
chemical_list: D007641:Keratolytic Agents; D017255:Acitretin