Harlequin ichthyosis (HI) is a rare type of congenital keratinization disorder that, when left untreated, usually leads to early neonatal demise. A clinical diagnosis of HI is considered when a patient presents with thick plate-like scaling of the skin together with eclabium, ectropion, and nasal hypoplasia. The diagnosis can be confirmed by genetic testing to determine mutation in the adenosine triphosphate-binding cassette A12 (ABCA12) gene. Early administration of systemic retinoids to promote desquamation and emollients to control excessive scaling and dryness of the skin lead to better prognosis in most cases of HI. We present the case of a 4-year-old male with HI who has been successfully managed with bland emollients and systemic acitretin therapy, which we started when he was 1 year old.
Acitretin

No abstract available.
Acitretin* ; Eczema* ; Hand*

OBJECTIVE: To evaluate effects of acitretin and methotrexate on treatment of severe plaque psoriasis.
 METHODS: A total of 54 patients were treated with either acitretin (32 patients; 30 mg per day) or methotrexate (22 patients; 15 mg per week) for 8 weeks. The therapeutic effects of the two drugs were evaluated according to the psoriasis area and severity index (PASI).
 RESULTS: After 8 weeks of treatment, the score of PASI decreased in both the acitretin group and the methotrexate group (P<0.001). However, there was no significant differences neither in the percentage reduction in the PASI score nor in PASI response rate between the two groups (P>0.05).
 CONCLUSION Acitretin and methotrexate exert similar therapeutic effect in severe plaque psoriasis.
Acitretin ; Humans ; Methotrexate ; Psoriasis

Introduction: Harlequin ichthyosis (HI) is a rare type of autosomal recessive congenital ichthyosis. There are approximately 200 documented cases worldwide, with less than five published reports in the Philippines. Despite its rarity, current literature suggests a better prognosis for these patients. Case description: We describe a preterm male newborn who presented at birth enclosed in a thick hyperkeratotic armor-like scale plates with areas of fissures, with associated ectropion, conjunctiva dehiscence, and eclabium. The thickened encasement also covered the hands and feet, causing severe contractures. A diagnosis of harlequin ichthyosis was given based on the clinical features. The patient was managed through a multidisciplinary approach, including referral to the tele-ichthyosis platform of a US-based foundation for patients with ichthyosis. Thermoregulation, nutrition, and hydration were carefully managed. Bland emollients were applied generously following normal saline soaks to improve barrier protection. Acitretin was administered on day 2 of life to facilitate the desquamation of the thickened encasement. A marked decrease in erythema and the thickness of the hyperkeratotic skin, and reduced conjunctival dehiscence were noted after one week of therapy. However, the constrictions on the hands and feet showed bluish discoloration and signs of necrosis. Linear band excision was performed to release the constrictors. Despite aggressive management, the patient succumbed to sepsis on day 12 of life. Conclusion Improved prognosis amongst HI patients is correlated with optimal quality of care regardless of resource limitations. A multidisciplinary approach and early administration of retinoids cannot be overemphasized. Linear band excision within the first week of life is suggested for constrictions on the extremities that do not improve with retinoids to avoid necrosis and autoamputation.
Ichthyosis, Lamellar ; Acitretin

Introduction: Granuloma annulare(GA) is a benign, inflammatory skin condition characterized by asymptomatic, flesh colored or erythematous papules. The disseminated variant of granuloma annulare is uncommon, usually affecting women older than 40 years. Case Summary: We report a case of a 52-year-old female, who presented with a 4-year history of skin colored to erythematous papules and annular plaques covering the entire skin surface. Correlation of the clinical presentation, histopathology and dermoscopy findings established the diagnosis of disseminated granuloma annulare. The patient was treated with 25 sessions of narrowband ultraviolet-B (NB-UVB) phototherapy and acitretin 20mg/day for 5 months. Conclusion Both histopathology and dermoscopy were noted to be valuable tools in the diagnosis of disseminated GA, as well as in monitoring response to the combined therapy.
Granuloma Annulare ; Dermoscopy ; Acitretin

A 5-year-old female presented a 4-year history of generalized well-demarcated asymptomatic brown to dark brown thin verrucous plaques with a Blaschkoid distribution. Histopathology was consistent with an epidermal nevus. Patient was diagnosed to have systematized verrucous epidermal nevus. Due to the extent of the lesions, surgical management was not feasible. Hence acitretin was given which showed partial decrease in the thickness of the lesions.

We have investigated the clinical response of 12 patients with erythrodermic psoriasis to therapy with etretinate. Initial dosage of etretinate was 20-60mg/day. The time for complete disappearance of scales averaged 19.9 days. In 10 of 12 patients(83.3%) satisfactory results were obtained after 2 to 11 months of treatment. Cheilitis was the most common side effect. Three patients had mild elevation of blood lipids, which was corrected by dose reduction. Remission period, of ten patients who showed good result, averaged 4.2 months.
Acitretin* ; Cheilitis ; Etretinate* ; Humans ; Psoriasis* ; Weights and Measures

The authors studied the plasma cholesterol levels in 39 rats (Sprague-Dawley) after 4 weeks administration of etretinate and/or fish oil. The study groups were as follows.'13 rats recieved etretinate only;13, fish oil only;13, both ertetinate and fish oil. Cholesterol levels were determined by standard enzymatic methodology. The results were as follows. Tot,al-cholesterol levels in rats following administration of ertetinate only were increased(p<0.05), but the levels in rats receiving fish oil only and both etretinate and fish oil were markedly decreased(p<0.01). HDL-cholesterol levels in rats following administration of fish oil and both etretinate and fish oil were decreased(p<0.01). The ratio of HDL-cholesterol to total-cholesterol in rats receiving fish oil only and both etretinate and fish oil were increased(p<0.05) because of markedly decreased total-cholesterol levels.
Acitretin* ; Animals ; Cholesterol* ; Etretinate* ; Plasma* ; Rats*

Hypertrophic lupus erythematosus is a clinical variant of chronic cutaneous lupus erythematosus (CCLE). It is critical to differentiate hypertrophic lupus erythematosus from CCLE because of treatment and prognosis. We report a case of hypertrophic lupus erythematosus with CCLE occured on arms. Combination therapy with acitretin and intralesional corticosteroid injection resulted in control of previously refractory skin lesion.
Acitretin ; Arm ; Lupus Erythematosus, Cutaneous ; Prognosis ; Skin

No abstract available.
Acitretin* ; Cyclosporine* ; Humans ; Psoriasis* ; Retrospective Studies*