Acitretin induced bipedal edema

Abstract

Generalized edema has been reported to be a rare side effect of systemic retinoids. We report a patient who developed localized bipedal edema from acitretin. Other causes of bipedal edema were excluded and withdrawal of acitretin led to resolution of the edema.

Efficacy and safety of acitretin in three fixed doses of 25, 35 and 50 mg in adult patients with severe plaque type psoriasis: a randomized, double blind, parallel group, dose ranging study

“…In an analysis of clinical trials involving 176 patients receiving acitretin in doses between 25 and 50 mg/day, cheilitis occurred in 60–75%, dry skin in 15–25%, alopecia, dry mouth and arthralgia in 10–25% of patients 18 . Pedal oedema, noted in two of our patients, has been a rarely reported adverse effect with acitretin therapy 25 …”

Bilateral pedal edema in an HIV patient: Lopinavir/Ritonavir-containing treatment regimen as a potential cause?

“…Psychiatric drugs reported to cause bilateral pedal edema include Olanzepine [9][10][11] and Lithium [12]. Acitretin, a retinoid used in psoriasis, has also been shown to cause bilateral pedal edema [13]. Our patient was neither on any psychiatric medication nor on a retinoid.…”

Hiperceratose epidermolítica: um seguimento de 23 anos de uso de retinoides orais

“…3,4 It is known that retinoids affect the amount of keratin in the human epidermis causing an increase of certain keratins (K4, K6, K13 and K19), while others decrease (K2e, K1 and K10) or show little or no response to treatment. 5 Acitretin is currently the most effective systemic treatment for the majority of severe cases of ichthyosis, 3 with its side effects thoroughly discussed in the literature: mucocutaneous changes (cheilitis, xerosis, nail abnormalities, hair loss are all dosedependent), liver toxicity (reversible elevation of transaminases and alkaline phosphatase), abnormalities of serum lipids (triglycerides and cholesterol) and the risk of teratogenicity.…”

“…Post-graduate student in dermatopathology at the University of Campinas (UNICAMP), Campinas (São Paulo), Brazil. 4 Post-graduate student in dermatologic surgery at the ABC Medical Faculty (FMABC), Santo André (São Paulo), Brazil. 5 Dermatologist, private clinic, Montes Claros (Minas Gerais), Brazil.…”