Two Years’ Experience with Tigason Treatment of Pustulosis palmo-plantaris and Eczema keratoticum manuum

Reymann, Flemming

doi:10.1159/000250092

Cited by 22 publications

(4 citation statements)

References 3 publications

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“…Etretinate has recently been found to be very effective in HDP (Reymann, 1982) but it had to be discontinued in five out of fifteen patients because of side-effects. The present study indicates that PUVA treatment could be an effective alternative to etretinate in severe cases of HDP.…”

Section: Discussionmentioning

confidence: 99%

Oral psoralen photochemotherapy (PUVA) of hyperkeratotic dermatitis of the palms

1983

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Section: Discussionmentioning

confidence: 99%

Oral psoralen photochemotherapy (PUVA) of hyperkeratotic dermatitis of the palms

1983

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“…Lowdose maintenance therapy with etretinate at approximately 10-20 mg/day is needed for long-term treatment in order to prevent relapse [4,5], Recently, some new data demonstrated that keratoderma climactericum of Haxthausen's responded well to etretinate [6], In keratosis lichenoides chronica [7], Kyrlc's disease [8] and con fluent and reticulated papillomatosis [9], some rare hyper-and dyskcratotic diseases, etretinate has been reported to produce good results within 3-4 weeks. Concerning its mechanism of action, etretinate inhibits the migration of neutrophilic and eo sinophilic granulocytes by a direct effect on cell motility [10], probably by changing the cells' capability to respond to chemoattrac tants or by modulating components of the epidermis or basal membrane zone to act as chemoattractants.…”

Section: Etretinatementioning

confidence: 99%

New Indications and New Retinoids

Gollnick¹

1987

Dermatology

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In addition to well-accepted indications, etretinate has a beneficial effect in a variety of other dermatoses such as the hyperkeratotic eczema of the palms and soles, prurigo nodularis, and other nonpsoriatic, sterile, pustular eruptions. Due to its influence on dermal inflammatory processes and immunomodulation of the tissue response, etretinate is effective in cutaneous lupus erythematosus, certain bullous disorders like pemphigus herpetiformis, the persistent variant of Grover’s disease, dermatitis herpetiformis, and bullous pemphigoid. Isotretinoin is reported to be effective in cutaneous sarcoidosis, disseminated granuloma annulare, systemic sclerosis and tumors of the cutaneous appendages. New synthetic retinoids have been developed. Etretin, the main metabolite of etretinate, was shown to be effective and to have a short elimination half-life of – 50 h. Arotinoid ethyl ester and arotinoid-free carboxylic acid are effective in minimal doses 500-fold lower than etretinate. Arotinoid ethyl ester was shown not to increase serum lipids. Arotinoid ethyl sulfone is the first retinoid without bone toxicity in animal experiments. Motretinide is the ethylamide of tretinoin and is reported to be effective in the local treatment of acne. Some of the new poly-aromatic retinoids appear to have sebosuppressive, antikeratinizing and/or anti-inflammatory effects via topical application.

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“…Palmoplantar pustular psoriasis (PPPP) responds poorly to topical treatment, but it does respond to photochemotherapy with psoralen and UV-A (PUVA) (Morison, Parrish & Fitzpatrick, 1978;Murray, Corbett & Warin, 1980) although the UV-A dose required may be considerable. Oral etretinate has also been used for PPPP (Jansen, Hollmen & Pajarre, 1979), but although there may be improvement few patients actually clear (Reymann, 1982) and an adequate therapeutic action is often limited by unacceptable side-effects. We therefore decided to see whether there was any advantage in combining etretinate with PUVA.…”

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A comparison of PUVA-etretinate and PUVA-placebo for palmoplantar pustular psoriasis

et al. 1984

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Seventeen patients with palmoplantar pustular psoriasis and three with hyperkeratotic psoriasis of palms and soles were treated with either PUVA-etretinate (1 mg/kg) or PUVA-placebo. Patients were randomly allocated to each group and the trial was conducted according to a double-blind protocol, so far as the side-effects of etretinate made this possible. PUVA was given three times a week for a maximum of 18 weeks, after 2 weeks on daily placebo or etretinate alone. All ten patients in the PUVA-etretinate group cleared, but there were four failures in the PUVA-placebo group (P = 0.03). The PUVA-etretinate treated patients required significantly fewer PUVA treatments (13.1 +/- 2.9; mean +/- s.e.) and cleared in a significantly shorter time (30.3 +/- 7.1 days) than the PUVA-placebo group (23.2 +/- 4.2 treatments; 59.2 +/- 11.5 days, P less than 0.05). The cumulative UV-A dose to clear was less in the PUVA-etretinate group (53.9 +/- 18.5 J/cm2) than the PUVA-placebo group (113.1 +/- 33.4 J/cm2). This difference was not significant due to the exceptionally large dose of UV-A used on one patient but the results were significant when it was excluded. The therapeutic advantage of adding etretinate to PUVA is offset by the side-effects of cheilitis, hair loss and peeling skin which occurred in eight of the ten PUVA-etretinate patients, and an increase in fasting triglyceride concentrations and serum alkaline phosphatase activity.

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Two Years’ Experience with Tigason Treatment of Pustulosis palmo-plantaris and Eczema keratoticum manuum

Cited by 22 publications

References 3 publications

Oral psoralen photochemotherapy (PUVA) of hyperkeratotic dermatitis of the palms

Oral psoralen photochemotherapy (PUVA) of hyperkeratotic dermatitis of the palms

New Indications and New Retinoids

A comparison of PUVA-etretinate and PUVA-placebo for palmoplantar pustular psoriasis

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