Hypertriglyceridaemia with acitretin use: a proposal for its management in the context of overall cardiovascular risk

Abstract

meticulous physical examinations and taking a detailed history were essential in considering metastatic disease, which was confirmed by performing a histological examination. We have described an uncommon case of digital cutaneous metastasis, which could easily have been overlooked. We emphasize the importance of maintaining a high index of suspicion of neoplastic processes for lesions associated with cases of atypical clinical histories or morphologies. References1 Sur YJ, Kang YK, Bahk WJ et al. Metastatic malignant tumour in the hand. J Plast Surg Hand Surg 2011; 45:90-5. 2 Gottlieb JA, Schermer DR. Cutaneous metastases from carcinoma of the colon. JAMA 1970; 213:2083. 3 Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 1993; 29:228-36. 4 Wu CY, Gao HW, Huang WH, Chao CM. Infection-like acral cutaneous metastasis as the presenting sign of an occult breast cancer. Clin Exp Dermatol 2009; 34:e409-10. 5 Flynn CJ, Danjoux C, Wong J et al. Two cases of acrometastasis to the hands and review of the literature. Curr Oncol 2008; 15:51-8.

Clinical Efficacy and Safety of Psoriasis Treatments in Patients with Concomitant Metabolic Syndrome: A Narrative Review

“…In 2021, the US Food and Drug Administration required an update of the package insert for tofacitinib and other JAK inhibitors to carry a warning of risk for serious heart-related events, blood clots, cancer, and death based on data from a clinical safety trial in high-risk patients treated with tofacitinib compared with TNF blockers [ 69 ]. The conventional systemic psoriasis therapies methotrexate, cyclosporine, and acitretin are also associated with an increased risk of hypertriglyceridemia or increased lipid levels; however, the implications of these changes are not known [ 55 , 70 , 71 ]. In contrast, biologics used in psoriasis treatment have minimal effects on serum lipid profile.…”

Pustular psoriasis in Malaysia: A review of the Malaysian Psoriasis Registry 2007–2018

“…In addition, acitretin also decreases the HDL fraction in 40% of patients 25 . High LDL/HDL ratio and hypertriglyceridemia are associated with cardiovascular risk 25,26 . Lipid abnormalities caused by acitretin typically reverses within 4–8 weeks after discontinuation 25 …”

“…25 High LDL/HDL ratio and hypertriglyceridemia are associated with cardiovascular risk. 25,26 Lipid abnormalities caused by acitretin typically reverses within 4-8 weeks after discontinuation. 25 Previous studies found that 28%-54% of GPP patients had scalp involvement.…”