title: Acitretin.
abstract: BACKGROUND
  Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory disease of the pilosebaceous follicle that severely affects patients' quality of life and can be challenging for clinicians to manage. A few case series have reported on the efficacy of acitretin monotherapy in the treatment of intractable HS.
  
  
  OBJECTIVE
  To assess the efficacy of acitretin for the treatment of intractable HS.
  
  
  METHODS
  A retrospective review was conducted involving all patients with HS who received acitretin between January 2011 and January 2015 in a tertiary academic medical center. All patients with HS who received acitretin, either as a monotherapy or as an adjuvant to other systemic medications, were included, and clinical response was assessed using the physician global scale.
  
  
  RESULTS
  Fourteen patients with HS (mean age 48 years [range 32-64 years]; 9 [64%] were men) received acitretin. Most patients (86%) had Hurley stage II or III disease. All patients had failed other standard systemic medications prior to initiating acitretin. Six patients (43%) received acitretin monotherapy, and 8 patients (57%) received acitretin as an adjuvant to other standard systemic medications. None of the patients who received acitretin monotherapy exhibited clinical improvements. Clinical improvements were observed in 7 of the 8 (87.5%) patients who received acitretin as an adjuvant to other systemic medications, with 3 patients (37.5%) exhibiting partial response and 4 patients (50%) exhibiting good response.
  
  
  CONCLUSIONS
  Acitretin monotherapy was ineffective for the treatment of intractable HS. Acitretin may be effective when used as an adjuvant to other systemic medications.
authors.affiliation: 1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Marcus G
authors.initials: MG
authors.lastname: Tan
authors.affiliation: 1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|2 Department of Medicine, Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Neil H
authors.initials: NH
authors.lastname: Shear
authors.affiliation: 1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|2 Department of Medicine, Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Walsh
authors.affiliation: 1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|2 Department of Medicine, Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Raed
authors.initials: R
authors.lastname: Alhusayen
mesh_terms: D017255:Acitretin / Q000627:therapeutic use*; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D017497:Hidradenitis Suppurativa / Q000188:drug therapy*; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D007641:Keratolytic Agents; D017255:Acitretin
keywords: acitretin; adjuvant therapy; combined therapy; hidradenitis suppurativa; monotherapy