title: The effects of alcohol on the metabolism and toxicology of anti-psoriasis drugs.
abstract: BACKGROUND
  Alcohol has long been suspected to be a triggering and precipitating factor of psoriasis. Alcohol misuse is common in patients with moderate-to-severe psoriasis and appears to impair treatment outcome.
  
  
  METHODS
  In this article, the authors review the available data regarding the metabolic and toxicological interactions between anti-psoriasis systemic drugs and ethanol and/or alcoholic beverages. Special attention is given to the influence of alcohol consumption on the hepatotoxic risk of some anti-psoriasis drugs. The article was prepared using a MEDLINE literature search.
  
  
  CONCLUSIONS
  The available knowledge highlights the existence of a few significant pharmacological interactions, such as the reduced exposure to cyclosporine by red wine, the possible increase of cyclosporine levels following a heavy acute alcohol intake, and, especially, the conversion of acitretin to etretinate, in the presence of ethanol, with important implications in females of child-bearing potential. There are limited data on the contributing role of alcohol in the hepatotoxicity induced by some anti-psoriasis drugs and the existing information on this topic is still controversial. However, further investigation is needed to assess the relevance of interactions between alcohol consumption and drug therapy for psoriasis, under both pharmacological and toxicological perspectives. Long-term prospective studies on large cohorts of patients are warranted to disclose the actual significance of such potential interactions in clinical practice.
authors.affiliation: University of Bari, Department of Biomedical Sciences and Human Oncology, Unit of Dermatology and Venereology, Bari, Italy. g.vena@dermatologia.uniba.it
authors.forename: Gino A
authors.initials: GA
authors.lastname: Vena
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Cassano
mesh_terms: D017255:Acitretin / Q000378:metabolism / Q000493:pharmacokinetics / Q000633:toxicity*; D000287:Administration, Topical; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000378:metabolism; D002908:Chronic Disease; D000431:Ethanol / Q000009:adverse effects* / Q000378:metabolism; D005050:Etretinate / Q000378:metabolism / Q000493:pharmacokinetics / Q000633:toxicity*; D005493:Folic Acid Antagonists / Q000493:pharmacokinetics / Q000633:toxicity; D006801:Humans; D007641:Keratolytic Agents / Q000493:pharmacokinetics / Q000633:toxicity*; D011565:Psoriasis / Q000188:drug therapy*; D012867:Skin / Q000187:drug effects / Q000473:pathology
chemical_list: D005493:Folic Acid Antagonists; D007641:Keratolytic Agents; D000431:Ethanol; D005050:Etretinate; D017255:Acitretin