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Acitretin


Presentation

  • In the present study, we assessed a young child presenting with ichthyosis and hepatomegaly, suggesting a diagnosis of CDS. We identified an intronic mutation, c.960 5G A, which was found to result in skipping of exon 6.[ncbi.nlm.nih.gov]
  • We present a case of severe erosive penile LP, successfully treated with oral acitretin after topical and oral corticosteroids failed to induce remission.[ncbi.nlm.nih.gov]
  • The present authors present this case for the unusual local aggressiveness of viral warts in an immunocompetent patient successfully treated with acitetrin.[ncbi.nlm.nih.gov]
  • Clinically pseudotumor cerebri presents with headache, diplopia, nausea, vomiting, papilloedema and if treatment is delayed, may lead to blindness.[ncbi.nlm.nih.gov]
  • Here we present a unique pediatric-onset case accompanied by pseudoepitheliomatous hyperplasia that posed a significant treatment challenge to dermatologists.[ncbi.nlm.nih.gov]
Fatigue
  • Body as a Whole: Hyperesthesia, paresthesias, arthralgia, progression of existing spinal hyperostosis, rigors, back pain, hypertonia, myalgia, fatigue, hot flashes, increased appetite.[robholland.com]
  • Adverse reactions CNS: headache, depression, insomnia, drowsiness, fatigue, migraine, rigors, abnormal gait, nerve inflammation, hyperesthesia, paresthesia, pseudotumor cerebri EENT: abnormal or blurred vision, dry eyes, eye irritation, eyebrow and eyelash[medical-dictionary.thefreedictionary.com]
  • Call your doctor immediately if you experience any of the following: Depression Suicidal thoughts Confusion Difficulty speaking Ear ringing Extreme fatigue Yellowing of the eyes or skin Vomiting Blurred vision Chest pains Slowed or irregular heartbeat[verywellhealth.com]
  • Your pharmacist may be able to advise you on managing side effects. abdominal pain abnormal hair texture back pain change in appetite cold or clammy skin diarrhea dry eyes dry mouth, chapped lips (especially in the first few weeks) dry skin earache fatigue[uniprix.com]
Inguinal Lesions
  • The patient was treated with oral acitretin for 1 year (with a topical corticosteroid for the inguinal lesions), resulting in clearing of the cutaneous lesions.[ncbi.nlm.nih.gov]
Turkish
  • In this report, we describe the clinicopathological and genetic features of a Turkish LP family with four cases, and evaluate the response of acitretin therapy.[ncbi.nlm.nih.gov]
Lymphedema
  • Elephantiasis nostras verrucosa is a rare disorder characterized by dermal fibrosis, hyperkeratotic, verrucous, and papillomatous lesions that result from both chronic filarial and nonfilarial lymphedema.[ncbi.nlm.nih.gov]
Arachnodactyly
  • Here, we present two cases of same family with HMS having all the cardinal features of HMS which includes palmo plantar keratoderma and periodontitis along with arachnodactyly, acroosteolysis, onychogryphosis, and marked osteopenia on hand wrist radiographs[ncbi.nlm.nih.gov]
Periodontitis
  • Treatment with acitretin resulted in excellent improvement of periodontitis, increase in the alveolar bone height, and periodontal attachment. Improvement remained stable at the end of 1-year follow-up.[ncbi.nlm.nih.gov]
  • Both the siblings were treated with cotrimoxazole, acetretin and topical keratolytics and followed up over a period of one year, showed remarkable improvement in palmo plantar keratoderma and periodontitis.[ncbi.nlm.nih.gov]
Hepatomegaly
  • The authors herein report an 18-month-old boy with ichthyosis and hepatomegaly diagnosed with CDS and confirmed to have a novel c.506-3C G mutation in the ABHD5/CGI-58 gene.[ncbi.nlm.nih.gov]
  • In the present study, we assessed a young child presenting with ichthyosis and hepatomegaly, suggesting a diagnosis of CDS. We identified an intronic mutation, c.960 5G A, which was found to result in skipping of exon 6.[ncbi.nlm.nih.gov]
Otalgia
  • […] appetite stimulation / Delayed / 1.0-10.0 diarrhea / Early / 1.0-10.0 abdominal pain / Early / 1.0-10.0 dysgeusia / Early / 1.0-10.0 back pain / Delayed / 1.0-10.0 myalgia / Early / 1.0-10.0 arthropathy / Delayed / 1.0-10.0 headache / Early / 1.0-10.0 otalgia[pdr.net]
Arthralgia
  • 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.[ncbi.nlm.nih.gov]
  • Common side effects include: cheilitis, rhinitis, dry mouth, arthralgia, spinal hyperostosis, alopecia, skin peeling, dry skin, nail disorder, pruritus, erythematous rash, hyperesthesia, paresthesia, paronychia, skin atrophy, sticky skin, alteration in[tevagenerics.com]
  • Body as a Whole: Hyperesthesia, paresthesias, arthralgia, progression of existing spinal hyperostosis, rigors, back pain, hypertonia, myalgia, fatigue, hot flashes, increased appetite.[robholland.com]
  • […] plaque 57.79 38.09 13 748 1685 3383413 Cushing's syndrome 57.08 38.09 12 749 1134 3383964 Exposure via body fluid 55.33 38.09 10 751 428 3384670 Skin exfoliation 53.93 38.09 17 744 8020 3377078 Drug-induced liver injury 52.41 38.09 15 746 5098 3380000 Arthralgia[drugcentral.org]
  • Musculo-skeletal system: Myalgia and arthralgia may occur and be associated with reduced tolerance to exercise. Bone pain has also been reported.[papaa.org]
Alopecia
  • Here we report a case of full body acitretin-induced poliosis with concurrent alopecia in a patient with psoriasis. A proposed mechanism for the poliosis is also presented here.[ncbi.nlm.nih.gov]
  • Abstract This study aimed to assess the efficacy of systemic retinoids in treating frontal fibrosing alopecia (FFA).[ncbi.nlm.nih.gov]
  • Other clinical symptoms include alopecia, desquamation of the skin, pruritus and 'sticky' skin. Changes in the lipid profile are often observed.[ncbi.nlm.nih.gov]
  • Alopecia and mucocutaneous symptoms such as cheilitis and drying of the mucous membranes are particularly prevalent. Hypertriglyceridaemia and elevation of cholesterol levels also occur.[ncbi.nlm.nih.gov]
  • Five patients discontinued therapy because of adverse, generally mild events that included xerosis/skin peeling (22%), chelitis (13%), dyslipidemia (13%), alopecia (9%) and depression (9%).[healio.com]
Eczema
  • Alitretinoin and acitretin are effective treatment options for patients with hand eczema. However, both treatments were more effective in patients with hyperkeratotic hand eczema.[ncbi.nlm.nih.gov]
  • However, the exact mechanisms for the effect on eczema are not known. Acitretin may be preferred in the treatment of hyperkeratotic hand eczema owing to its modulating effect on keratinization.[ncbi.nlm.nih.gov]
  • Rosacea, Acne, Shingles: Common Adult Skin Diseases Learn to spot and treat skin conditions commonly found in adults such as acne, eczema, shingles, psoriasis, rosacea, hives, cold...[medicinenet.com]
  • Multimedia: Slideshows, Images & Quizzes Rosacea, Acne, Shingles: Common Adult Skin Diseases Learn to spot and treat skin conditions commonly found in adults such as acne, eczema, shingles, psoriasis, rosacea, hives, cold...[medicinenet.com]
  • Alitretinoin used for hand eczema is classified in D11A. ATC code Name DDD U Adm.R Note D05BB02 acitretin 35 mg O List of abbreviations Last updated: 2018-12-13[whocc.no]
Follicular Hyperkeratosis
  • Spiny follicular hyperkeratosis (SFH) is follicular flesh-colored hyperkeratotic spicules that are linked to different situations including drug reactions. Previously suspected drugs are BRAF inhibitors and cyclosporine.[ncbi.nlm.nih.gov]
Sexual Dysfunction
  • When LP involves the genitalia it may present as painful, pruritic erosions that can be exquisitely tender, causing distress and genitourinary and sexual dysfunction. Management of erosive genital LP is often suboptimal.[ncbi.nlm.nih.gov]
Headache
  • Clinically pseudotumor cerebri presents with headache, diplopia, nausea, vomiting, papilloedema and if treatment is delayed, may lead to blindness.[ncbi.nlm.nih.gov]
  • Other possible side effects include: Blurred vision and/or decreased night vision Muscle aches and joint pains or stiffness Hair loss – usually temporary and reversible when the medication is stopped Headaches.[dermcoll.edu.au]
  • In addition, it may cause nausea, headache, itching, dry, red or flaky skin, dry or red eyes, dry or chapped lips, swollen lips, dry mouth, thirst, cystic acne or hair loss. [2] [3] [4] Pharmacokinetics [ edit ] It is a metabolite of etretinate, which[en.wikipedia.org]
  • , problems with speech or balance, swelling or warmth in one or both legs; high blood sugar --increased thirst, increased urination, dry mouth, fruity breath odor, headache, blurred vision; increased pressure inside the skull --severe headaches, ringing[highlakeshealthcare.com]
Responsiveness Decreasing
  • ; decreases polymorphonuclear leukocyte migration/accumulation; and increases the number of Langerhans cells in normal and psoriatic skin. 4 6 8 9 17 19 Exhibits antineoplastic activity in vitro. 17 Has teratogenic effects. 1 (See Boxed Warning.)[drugs.com]

Workup

  • Monitoring Prior to starting a patient on acitretin, obtain a medical history and perform a baseline workup, including baseline liver function tests and lipid panel ( Table 2 ).[the-dermatologist.com]

Treatment

  • The treatment with systemic retinoids lasted between 12 and 16 months (the mean duration of treatment was 13.5 months).[ncbi.nlm.nih.gov]
  • OBJECTIVE: To evaluate the efficacy of NB-UVB, Goeckerman therapy and the effect of addition of retinoid to the treatment regimen in the treatment of psoriasis,.[ncbi.nlm.nih.gov]
  • Although several new drugs have recently been introduced for the treatment of skin psoriasis, treatment of nail psoriasis still remains a challenge.[ncbi.nlm.nih.gov]
  • 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.[ncbi.nlm.nih.gov]
  • Thanks to its lack of a direct immunosuppressive effect and its ability to achieve a long-term response, acitretin has an important role in the treatment of psoriasis, although this has not always been acknowledged in relevant treatment guidelines.[ncbi.nlm.nih.gov]

Etiology

  • The exact etiology of PPPK has not been fully understood. Furthermore, no standardized treatment for PPPK has been established and treatment options are limited.[ncbi.nlm.nih.gov]
  • Pityriasis rubra pilaris is a chronic inflammatory dermatosis of unknown etiology and great clinical variability. It has been divided into six categories.[ncbi.nlm.nih.gov]
  • Evaluate human papillomavirus (HPV) as a possible etiologic cofactor in the development of cutaneous epidermal dysplasia/carcinoma from skin tissues of these patients.[clinicaltrials.gov]
  • Among the many etiologic mechanisms proposed dermal T-lymphocyte mediated autoimmunity is considered most likely. These cells after activation produce cytokines such as interferon-α.[ijdd.in]
  • If hepatotoxicity is suspected, discontinue acitretin and investigate the etiology.[pdr.net]

Epidemiology

  • ABSTRACT:Background: Studies have identified numerous genetic polymorphisms associat... more Skin Cancer Epidemiology and Sun Protection Behaviors Among Native American....[jddonline.com]
Sex distribution
Age distribution

Prevention

  • Strict pregnancy prevention is required in women of childbearing potential who use acitretin.[ncbi.nlm.nih.gov]
  • It also has been shown to have chemo-preventative characteristics. Acitretin is limited by its teratogenicity and therefore considered inappropriate in most female patients of childbearing age.[ncbi.nlm.nih.gov]
  • Our case provides further supporting evidence for acitretin as a useful treatment for KCM to induce remission, prevent extensive surgery and minimise destructive scarring.[ncbi.nlm.nih.gov]
  • The supplementary topical therapy may be useful in reducing the dose of systemic retinoids and preventing potential toxicity.[ncbi.nlm.nih.gov]
  • We report a case of an HIV-positive patient with acquired EDV who achieved sustained clinical resolution even after discontinuation of oral acitretin by applying topical imiquimod to prevent recurrence of his lesions.[ncbi.nlm.nih.gov]

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