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Use of retinoids in the treatment of psoriasis.
Clin Pharm. 1989 May; 8(5):344-51.CP

Abstract

The limitations of conventional therapy for psoriasis are reviewed, and the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, dosing and therapeutic monitoring of etretinate and other retinoids are described. Traditional treatments for psoriasis include topical application of anthralin and coal tar ointments; systemic therapy with corticosteroids or methotrexate; and systemic or methotrexate; and systemic psoralens combined with exposure to ultraviolet light (PUVA). The topical therapies are beneficial but aesthetically displeasing to patients; the systemic treatments are associated with severe adverse reactions. Etretinate provides another option in the treatment of psoriasis. Etretinate and acitretin, an investigational retinoid, appear to be effective oral therapies for severe variants of psoriasis, especially pustular psoriasis. Retinoids generally do not offer substantial therapeutic advantages over other treatments for chronic-plaque psoriasis. The most common adverse effects of etretinate are cheilitis, alopecia, desquamation of the skin, drying of mucous membranes, and pruritus. Use of low-dose etretinae in combination with other forms of therapy, such as corticosteroids or PUVA, may minimize the frequency of adverse effects. Etretinate is a known teratogen. Its elimination half-life is prolonged to 100-120 days with long-term use. Acitretin, the carboxylic acid derivative of etretinate, has a much shorter elimination half-life than etretinate (50 hours after multiple doses). Its adverse-effect profile is similar to that of etretinate. Etretinate and acitretin appear to be clinically effective for therapy of severe variants of psoriasis. Etretinate should not be used to treat mild psoriasis because of the high incidence of serious adverse effects.

Authors+Show Affiliations

University of Michigan Hospitals, Ann Arbor 48109-0008.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

2663325

Citation

Warren, E W., and U Khanderia. "Use of Retinoids in the Treatment of Psoriasis." Clinical Pharmacy, vol. 8, no. 5, 1989, pp. 344-51.
Warren EW, Khanderia U. Use of retinoids in the treatment of psoriasis. Clin Pharm. 1989;8(5):344-51.
Warren, E. W., & Khanderia, U. (1989). Use of retinoids in the treatment of psoriasis. Clinical Pharmacy, 8(5), 344-51.
Warren EW, Khanderia U. Use of Retinoids in the Treatment of Psoriasis. Clin Pharm. 1989;8(5):344-51. PubMed PMID: 2663325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of retinoids in the treatment of psoriasis. AU - Warren,E W, AU - Khanderia,U, PY - 1989/5/1/pubmed PY - 1989/5/1/medline PY - 1989/5/1/entrez SP - 344 EP - 51 JF - Clinical pharmacy JO - Clin Pharm VL - 8 IS - 5 N2 - The limitations of conventional therapy for psoriasis are reviewed, and the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, dosing and therapeutic monitoring of etretinate and other retinoids are described. Traditional treatments for psoriasis include topical application of anthralin and coal tar ointments; systemic therapy with corticosteroids or methotrexate; and systemic or methotrexate; and systemic psoralens combined with exposure to ultraviolet light (PUVA). The topical therapies are beneficial but aesthetically displeasing to patients; the systemic treatments are associated with severe adverse reactions. Etretinate provides another option in the treatment of psoriasis. Etretinate and acitretin, an investigational retinoid, appear to be effective oral therapies for severe variants of psoriasis, especially pustular psoriasis. Retinoids generally do not offer substantial therapeutic advantages over other treatments for chronic-plaque psoriasis. The most common adverse effects of etretinate are cheilitis, alopecia, desquamation of the skin, drying of mucous membranes, and pruritus. Use of low-dose etretinae in combination with other forms of therapy, such as corticosteroids or PUVA, may minimize the frequency of adverse effects. Etretinate is a known teratogen. Its elimination half-life is prolonged to 100-120 days with long-term use. Acitretin, the carboxylic acid derivative of etretinate, has a much shorter elimination half-life than etretinate (50 hours after multiple doses). Its adverse-effect profile is similar to that of etretinate. Etretinate and acitretin appear to be clinically effective for therapy of severe variants of psoriasis. Etretinate should not be used to treat mild psoriasis because of the high incidence of serious adverse effects. SN - 0278-2677 UR - https://www.unboundmedicine.com/medline/citation/2663325/Use_of_retinoids_in_the_treatment_of_psoriasis_ L2 - http://www.diseaseinfosearch.org/result/6059 DB - PRIME DP - Unbound Medicine ER -
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