Systemic Therapy for Psoriasis

Melvin Lee, MD; Robert E. Kalb, MD


Dermatology Nursing. 2008;20(2):105-111. 

In This Article

Acitretin (Soriatane®)

Acitretin, like all retinoids, promotes the differentiation of keratinocytes. It is useful in combination with other therapies, particularly with phototherapy, or as a maintenance therapy after control with a faster-acting agent (Hodulik & Zeichner, 2006; Spuls, Rozenblit, & Lebwohl, 2003). Dosing of acitretin is usually started at 10 to 25 mg per day, with a slow titration up in dose. Recent studies have shown that adverse events are much more common in high-dose regimens (50 mg daily) as compared to low-dose regimens (25 mg daily) (Pearce et al., 2006). Higher doses of acitretin are often limited by the common side effects, including dry lips, dry eyes, xerosis, hair loss, and myalgias. Experienced patients can adjust the dosing of acitretin themselves de pending on disease activity and side effects.

More serious adverse effects of acitretin include teratogenicity, hepatotoxicity, and hyperlipidemia (Pearce et al., 2006).


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