Etretinate Therapy for Psoriasis

Ellis, Charles N.; Kang, Sewon; Grekin, Roy C.; LoBuglio, Albert F.; Voorhees, John J.

doi:10.1001/archderm.1985.01660070067017

Cited by 25 publications

(30 citation statements)

References 13 publications

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“…Retinoids promote differentiation, and inhibit PMN migration and clonal growth of leukemic cell lines in vitro [6][7][8][9][10]. However, toxicity and in particular teratogenicity have limited their use [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Effects of Systemic Treatment with Liarozole on Cutaneous Inflammation, Epidermal Proliferation and Differentiation in Extensive Plaque Psoriasis

Pelt¹,

Jong²,

Bakker³

et al. 1998

Skin Pharmacol Physiol

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Liarozole is a novel inhibitor of the enzyme cytochrome P₄₅₀ which has inhibitory effects on the 4-hydroxylation of retinoic acid. Previous studies have shown that liarozole is effective in the treatment of psoriasis. We performed an immunohistochemical study on the lesional skin from 7 patients with extensive plaque psoriasis, who were treated with systemic liarozole 75 mg BID for a period of at least 2 months. The effects of liarozole treatment on clinical and histological parameters were investigated. In particular, the effect of liarozole on the integrin markers CD11b and CD18 was studied.For immunohistochemistry, three consecutive biopsies were taken: before treatment, after 4, and after 8 weeks of treatment. Clinical scores and side effects were recorded before and during treatment.The medication was well tolerated and only mild side effects were reported, which were comparable with hypervitaminosis A. After 2 months of treatment a statistically significant decrease of the extent of body involvement was observed. In the psoriatic plaque, markers for epidermal proliferation and cutaneous inflammation decreased, and markers for epidermal differentiation increased to values comparable to normal skin. The first therapeutic effects in the psoriatic plaque occurred after 4 weeks of treatment, and consisted of a decreased induration, accompanied by a decrease of the total number of inflammatory infiltrate cells and a decreased epidermal ICAM-1 expression. Already after 4 weeks of treatment, a decrease of CD11b-positive cells was observed. Subsequently, after 8 weeks of treatment the recruitment of cycling epidermal cells and the number of involucrin-positive cell layers decreased.The present study demonstrates that liarozole treatment of psoriasis results in a reduction of aspects of cutaneous inflammation and subsequently a reduction of epidermal proliferation and promotion of differentiation. After 4 weeks of treatment, effects are observed on the epidermal ICAM-1 expression and on the CD11b-positive cell population.

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Section: Introductionmentioning

confidence: 99%

Effects of Systemic Treatment with Liarozole on Cutaneous Inflammation, Epidermal Proliferation and Differentiation in Extensive Plaque Psoriasis

Pelt¹,

Jong²,

Bakker³

et al. 1998

Skin Pharmacol Physiol

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“…One of our 2 patients in fact received a total dose of etretinate of about 15 g, which is comparable to the dose administered to the patients studied by Gilbert et al [1]. Since OPLL is a rare condition which has main ly been studied in Japan [5] it is possible that this con dition has until now been overlooked in patients treat ed with retinoids.…”

Section: Discussionmentioning

confidence: 56%

“…[1] regarding the lack of skeletal radiographic changes during short term etretinate therapy for psoriasis prompt us to report a peculiar skeletal involvement that we have ob served in 2 patients treated with etretinate for keratinization disorders.…”

mentioning

confidence: 89%

Ossification of the Posterior Longitudinal Ligament Associated with Etretinate Therapy

et al. 1987

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“…Acitretin has the major advantage of a much shorter half-life (50 h us 120 days) but can be partially metaboIized to etretinate, particularly when ingested with ethanol (39) and so pregnancy is not considered safe for 2 years after treatment with either Results of retinoid therapy are u s d y noted within 6 weeks in plaque psoriasis and within 2 weeks in erythrodermic forms. Most patients show improvement; in one study over 90% of patients achieved at least a 50% clearance of their disease (40). Acitretin is expensive and, in view of the difficulties involved in its drug.…”

Section: Retinoidsmentioning

confidence: 99%