alitretinoin and Ichthyosis

Topics: Adult; Alitretinoin; Deafness; Female; Humans; Ichthyosis; Keratitis; Tretinoin

For disorders of keratinization, topical treatment alone may be ineffective, and systemic retinoid therapy may be indicated. Treatment with systemic retinoids (acitretin, isotretinoin and alitretinoin) has been shown to be effective in reducing disease severity; however, potentially rare adverse effects (AEs) may occur, including hyperostotic skeletal changes. The true prevalence of this AE in adult patients administered life-long therapy is unknown. We identified 3 of 127 (2.4%) patients (with ichthyosis or Darier disease) who had been prescribed isotretinoin with or without acitretin, and who developed radiological signs and clinical symptoms of hyperostosis and ligamentous ossification. This clinical review highlights the significance of retinoid-induced skeletal hyperostosis in patients prescribed long-term, high-dose retinoid therapy for disorders of keratinization. Patients commencing systemic retinoid therapy, particularly women of childbearing age, should be counselled about this important and potentially serious AE, especially if long-term treatment is indicated.

Topics: Acitretin; Adult; Alitretinoin; Female; Humans; Hyperostosis; Ichthyosis; Isotretinoin

Acitretin is the main retinoid used to treat severe inherited ichthyosis. Alternatives may be considered if it results ineffective or there are side-effects, or for women of childbearing age. Our objective is evaluation of the effects and tolerance of alitretinoin. An observational retrospective multicentric study was designed to analyse patients with inherited ichthyosis treated by alitretinoin.. A total of 13 patients were included, 11 of whom were receiving acitretin at inclusion. The main reason for switching to alitretinoin was a desire for pregnancy, but also because of side-effects or unsatisfactory efficacy. Starting dose was 10 mg/day, increased to 20 or 30 mg/day. Alitretinoin seemed to be more effective than acitretin at reducing erythema, but was less effective at reducing scaling or hyperkeratosis. Global efficacy was considered low for two patients, moderate for nine, and high for two. Treatment was well-tolerated, except for one patient who presented with benign intracranial hypertension leading to discontinuation of treatment.. Alitretinoin may be suitable for hereditary ichthyosis with prominent erythema, especially for women of childbearing age.

Topics: Adult; Alitretinoin; Child; Dermatologic Agents; Erythema; Female; Genetic Predisposition to Disease; Humans; Ichthyosis; Male; Retrospective Studies; Young Adult

Topics: Adolescent; Alitretinoin; Biopsy; Cellulitis; Deafness; Dermatologic Agents; Humans; Ichthyosis; Keratitis; Male; Scalp Dermatoses; Skin; Skin Diseases, Genetic; Treatment Outcome; Tretinoin