title: Effectiveness and Safety of Acitretin in Children with Plaque Psoriasis: A Multicenter Retrospective Analysis.
abstract: BACKGROUND
  Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis.
  
  
  METHODS
  Retrospective analysis of a group of children and adolescents (<17 years of age) with moderate to severe plaque psoriasis treated with acitretin between 2010 and 2014 at Italian dermatology clinics. Patients were identified through databases or registries.
  
  
  RESULTS
  The study population consisted of 18 patients with a median age of 9.5 years at the start of therapy. The median maintenance dosage per day was 0.41 mg/kg. Eight patients (44.4%) achieved complete clearance or good improvement of their psoriasis, defined as improvement from baseline of 75% or more on the Psoriasis Area and Severity Index at week 16. Three had three or more courses of treatment with short disease-free intervals. In three patients, acitretin treatment was ongoing at the time of data collection. The mean total duration of treatment in responders was 22.7 months. One patient discontinued treatment because of arthralgia. The remaining nine patients (50%) discontinued treatment because it was ineffective. Mucocutaneous adverse effects occurred in all patients, but did not affect therapy maintenance.
  
  
  CONCLUSIONS
  In this retrospective case series, acitretin was a moderately effective, well-tolerated treatment in children with moderate to severe plaque psoriasis. Given the small number of patients, statements about long-term safety are not possible.
authors.affiliation: Dermatology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. vito.dilernia@asmn.re.it.
authors.forename: Vito
authors.initials: V
authors.lastname: Di Lernia
authors.affiliation: Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy.
authors.forename: Domenico
authors.identifier: http://orcid.org/0000-0002-1319-4946
authors.initials: D
authors.lastname: Bonamonte
authors.affiliation: Dermatology Unit, Department of Head and Neck Surgery, University of Modena, Modena, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Lasagni
authors.affiliation: Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Belloni Fortina
authors.affiliation: UOC Dermatologia Pediatrica, Ospedale Maggiore, Policlinic of Milan, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cambiaghi
authors.affiliation: Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Corazza
authors.affiliation: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University Hospital, Parma, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Di Nuzzo
authors.affiliation: Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gisondi
authors.affiliation: Department of Dermatology, University of Turin, Turin, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Panzone
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Guarneri
authors.affiliation: Division of Dermatology, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Iria
authors.initials: I
authors.lastname: Neri
mesh_terms: D017255:Acitretin / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007641:Keratolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D061214:Patient Safety; D011565:Psoriasis / Q000175:diagnosis* / Q000188:drug therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D007641:Keratolytic Agents; D017255:Acitretin