Acitretin in psoriasis: An overview of adverse effects

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

“…[86][87][88] Potential teratogenic effects associated with retinoids are characteristic of those associated with hypervitaminosis A. 89,90 Retinoid embryopathy can result in craniofacial dysmorphias such as high palate and anophthalmia, abnormalities of appendages including syndactyly and absence of terminal phalanges, malformations of the hip, meningoencephalocele, and multiple synostosis. [89][90][91][92] The teratogenic risk is particularly high for women exposed to treatment during the first trimester of pregnancy.…”

“…89,90 Retinoid embryopathy can result in craniofacial dysmorphias such as high palate and anophthalmia, abnormalities of appendages including syndactyly and absence of terminal phalanges, malformations of the hip, meningoencephalocele, and multiple synostosis. [89][90][91][92] The teratogenic risk is particularly high for women exposed to treatment during the first trimester of pregnancy. Available data do not appear to indicate any reproductive safety risks due to paternal treatment with acitretin.…”

“…22,90 Severe hepatotoxic reactions resulting from retinoid use are rare, and reports include a severe cholestatic hepatitis occurring in a patient with a hypoplastic kidney, 11,96 and a severe hepatotoxic reaction with progression to liver cirrhosis. 90,97,98 However, data from 1877 patients receiving acitretin therapy showed overt chemical hepatitis in only 0AE26%. 90 A total of 83 patients followed by liver biopsy for 2 years showed no significant hepatotoxicity with acitretin other than mild changes.…”

“…90,97,98 However, data from 1877 patients receiving acitretin therapy showed overt chemical hepatitis in only 0AE26%. 90 A total of 83 patients followed by liver biopsy for 2 years showed no significant hepatotoxicity with acitretin other than mild changes. 97 Alcoholics, diabetics and obese individuals are at increased risk for hepatotoxicity and require more frequent liver function studies.…”

“…Increases of serum triglycerides to levels associated with pancreatitis are not common, although one case of fatal fulminant pancreatitis has been reported. 90 These changes in the lipid profile are dose related and may be controlled by dietary means (including restriction of alcohol intake) and ⁄or by reduction of dosage of acitretin. A high fish oil diet was found effective in partially reducing hypertriglyceridaemia and increasing HDL cholesterol in patients treated with etretinate and acitretin.…”