tretinoin and Foot-Dermatoses

Topics: Baths; Calcinosis; Cat-Scratch Disease; Child; Diabetes Mellitus, Type 1; Folliculitis; Foot Dermatoses; Herpes Simplex; Humans; Hyperhidrosis; Isomerism; Isotretinoin; Joint Diseases; Lyme Disease; Skin Diseases; Tinea; Tretinoin

Palmoplantar pustulosis (PPP) is an inflammatory, debilitating skin disease. Topical drugs and systemic immunosuppressive agents are often ineffective. Previous uncontrolled studies have suggested that alitretinoin could be a meaningful treatment option for PPP.. The primary objective was to determine response to alitretinoin for the treatment of PPP based on the Palmoplantar Pustulosis Area and Severity Index (PPPASI) after 24 weeks of treatment.. A phase II, randomized, double-blind, placebo-controlled, multicentre study. Adult patients with PPP (with or without psoriasis) refractory to topical therapy and standard skin care were randomized 2:1 to alitretinoin 30 mg once daily or placebo for up to 24 weeks. The primary end point was PPPASI at week 24 (or the last visit in case of early withdrawal). Secondary end points included: percentage change from baseline in the modified Psoriasis Area and Severity Index (mPASI); percentage of patients with ≥ 50% or 75% improvement in PPPASI or mPASI scores from baseline; change in pustule count on the palms and soles; change in the Nail Psoriasis Severity Index and safety and tolerability assessments.. Thirty-three patients were randomized: 24 patients to alitretinoin 30 mg and nine to placebo. Overall, there were no significant differences between alitretinoin 30 mg and placebo for any end point. The safety profile was consistent with that seen in patients with chronic severe hand eczema refractory to potent topical corticosteroids.. Although the results were unexpected based on previous studies of alitretinoin in the treatment of PPP, this study provided no evidence to support further exploration of alitretinoin in the treatment of severe PPP.

Topics: Administration, Cutaneous; Administration, Oral; Alitretinoin; Dermatologic Agents; Double-Blind Method; Drug Administration Schedule; Female; Foot Dermatoses; Hand Dermatoses; Humans; Male; Middle Aged; Psoriasis; Severity of Illness Index; Treatment Outcome; Tretinoin

Six patients with persistent palmoplantar pustulosis were treated with acitretin, and the clinical response was compared with the effect on the intra-epidermal accumulation of polymorphonuclear PMN leukocytes. A prompt improvement of pustule formation and subsequently decreased scaling and erythema was seen in all patients. Following discontinuation of therapy, a relapse occurred within 2 weeks. With dosages of 45 or 55 mg/day, the clinical scores were only slightly better than with 25 or 35 mg/day. In patients using 25 mg acitretin a day, the leukotriene B4-induced intra-epidermal accumulation of polymorphonuclear leukocytes was not affected. However, a dosage of 35 mg/day resulted in a significant inhibition of PMN accumulation, dosages of 45 and 55 mg/day causing an even more pronounced inhibition of this process. Although the effect of different dosages of acitretin is not clearly expressed in the severity scores, the dose-dependent effect on PMN chemotaxis in vivo might be of relevance when combination therapies are considered, in order to achieve a complete clinical clearance.

Topics: Acitretin; Adult; Chemotaxis, Leukocyte; Clinical Trials as Topic; Drug Tolerance; Female; Foot Dermatoses; Hand Dermatoses; Humans; Male; Middle Aged; Neutrophils; Psoriasis; Skin Diseases, Vesiculobullous; Tretinoin

Sixty patients with palmoplantar pustulosis were treated in a double-blind trial with either acitretin (etretin, Ro 10-1670) or with etretinate. The study consisted of 4 weeks of therapy with three 10 mg capsules/day followed by 8 weeks of therapy with a varying number of capsules given daily according to therapeutic response. At the end of the 12-week treatment period, the mean number of pustules (+/- SEM) had decreased from 57.8 (+/- 8.6) to 3.9 (+/- 1.6) in the acitretin group and from 57.1 (+/- 14.1) to 5.7 (+/- 2.7) in the etretinate group. With regard to influence on erythema, infiltration, scaling, and area involved, similar improvements were obtained in both treatment groups. Adverse reactions of the hypervitaminosis A type were observed with almost the same frequency and severity in both treatment groups. The mean number of 10 mg capsules used daily was comparable in the two groups: 2.82 (range 1.23-4.67) for acitretin and 2.77 (range 1.60-4.82) for etretinate. It can be concluded that acitretin and etretinate do not significantly differ with regard to efficacy and overall safety in the treatment of patients with palmoplantar pustulosis.

Topics: Acitretin; Adult; Aged; Clinical Trials as Topic; Double-Blind Method; Etretinate; Female; Foot Dermatoses; Hand Dermatoses; Humans; Male; Middle Aged; Random Allocation; Tretinoin

In a double-blind, cross-over trial with Tigason and placebo, the parameters of palmoplantar pustulosis underwent significant changes during the retinoid therapy. A hand-over effect was clearly indicated during the placebo period and several patients experienced long-lasting remissions.

Topics: Adult; Aged; Clinical Trials as Topic; Dermatologic Agents; Double-Blind Method; Etretinate; Female; Foot Dermatoses; Hand Dermatoses; Humans; Middle Aged; PUVA Therapy; Scalp Dermatoses; Suppuration; Tretinoin

Nineteen patients with chronic, recalcitrant palmoplantar pustulosis took either placebo or aromatic retinoid ethyl ester (Ro 10-9359) during a 4-month therapeutic trial. The maximal dose of Ro 10-9359 varied between 25 and 100 mg per day, according to the individual patient's tolerance. An excellent or good therapeutic response was obtained in 6 out of 9 patients on the active medication and in 2 out of 10 patients on placebo. The difference in therapeutic response between the Ro 10-9359 group and the placebo group was statistically significant (p less than 0.05). Drying and chapping of the lips was the most common side effect of Ro 10-9359 treatment.

Topics: Adult; Aged; Clinical Trials as Topic; Double-Blind Method; Drug Evaluation; Female; Foot Dermatoses; Hand Dermatoses; Humans; Male; Middle Aged; Placebos; Tretinoin; Vitamin A

Topics: Administration, Oral; Alitretinoin; Dermatologic Agents; Female; Foot Dermatoses; Hand Dermatoses; Humans; Keratoderma, Palmoplantar; Treatment Outcome; Tretinoin; Young Adult

Topics: Alitretinoin; Antineoplastic Agents; Female; Foot Dermatoses; Hand Dermatoses; Humans; Middle Aged; Mycosis Fungoides; Skin Neoplasms; Treatment Outcome; Tretinoin

Topics: Alitretinoin; Chronic Disease; Cyclosporine; Dermatologic Agents; Drug Substitution; Eczema; Foot Dermatoses; Hand Dermatoses; Humans; Male; Middle Aged; Nail Diseases; Nails, Malformed; Time Factors; Treatment Outcome; Tretinoin

Topics: Alitretinoin; Chronic Disease; Eczema; Female; Foot Dermatoses; Humans; Middle Aged; Remission Induction; Tretinoin

Topics: Adult; Alitretinoin; Animal Husbandry; Animals; Dermatitis, Occupational; Dermatologic Agents; Female; Foot Dermatoses; Hand Dermatoses; Horses; Humans; Tretinoin

Topics: Adult; Alitretinoin; Dermatologic Agents; Foot Dermatoses; Hand Dermatoses; Humans; Keratoderma, Palmoplantar; Male; Tretinoin

Topics: Alitretinoin; Chronic Disease; Dermatologic Agents; Female; Foot Dermatoses; Hand Dermatoses; Humans; Middle Aged; Politics; Quality of Life; Tretinoin

Lesional and perilesional skin samples from a 57-year-old man who had hyperkeratosis lenticularis perstans (HLP) (Flegel's disease) were studied by light and electron microscopic examination. Keratohyalin granules were diminished at the center of a fully-developed lesion. In contrast, keratohyalin appeared normal and membrane-coating granules were found in reduced numbers at the edges of the HLP lesion and were easily detected in normal numbers in clinically normal, perilesional skin. The inflammatory infiltrate in the HLP lesion was composed of small lymphocytes, which often displayed nuclei with deep infoldings resembling Sézary cells, and larger histiocytic cells, many of which were in close contact with the lymphocytes. Peripheral blood mononuclear cells did not show an abnormal ultrastructural appearance. Treatment with topical 5-fluorouracil cream led to the disappearance of the HLP lesions, whereas topical tretinoin was ineffective.

Topics: Administration, Cutaneous; Fluorouracil; Foot Dermatoses; Humans; Keratosis; Leg Dermatoses; Male; Middle Aged; Skin; Tretinoin

The effects of acitretin (free acid of etretinate) on the serum lipoprotein pattern and on the fat elimination in serum of 8 patients with psoriasis and 4 with palmo-plantar pustulosis were studied. The drug was given for 12 weeks; the average daily dose was 40 mg. Lipoprotein analyses and an intravenous fat tolerance test (IVFTT) were performed on three occasions (before, after 8 weeks' treatment, as well as 8 weeks after the end of the treatment). Acitretin increased the triglyceride concentration of the very low density lipoproteins by about 50% (p less than 0.02) and reduced the cholesterol of the high density lipoproteins significantly (p less than 0.001), leading to an increased low density/high density lipoprotein cholesterol ratio (p less than 0.02). The IVFTT indicated a lowering of the fat elimination capacity. All changes reverted to the original values after an 8-week wash-out period. The data suggest that the effects of acitretin on the lipoprotein metabolism resemble those of etretinate and isotretinoin.

Topics: Acitretin; Adult; Apolipoproteins; Cholesterol; Fat Emulsions, Intravenous; Female; Foot Dermatoses; Hand Dermatoses; Humans; Lipids; Lipoproteins; Male; Middle Aged; Psoriasis; Skin Diseases, Vesiculobullous; Tretinoin

Topics: Adult; Foot; Foot Dermatoses; Humans; Immunologic Deficiency Syndromes; Isotretinoin; Male; Tretinoin; Warts

Topics: Adult; Earache; Etretinate; Female; Foot Dermatoses; Humans; Suppuration; Tretinoin

A disabling case of keratodermia palmoplantare papuloverrucoides progressiva is described. Less severe cases have been reported in the American literature as keratodermia punctata. The verrucoid lesions of our patient were spontaneously shed during treatment with the aromatic retinoid etretinate, and a daily maintenance dose of 25 mg was necessary to prevent recurrence.

Topics: Adult; Etretinate; Foot Dermatoses; Hand Dermatoses; Humans; Keratoderma, Palmoplantar; Male; Middle Aged; Tretinoin; Warts

Topics: Eczema; Etretinate; Female; Foot Dermatoses; Hand Dermatoses; Humans; Keratoderma, Palmoplantar; Male; Middle Aged; Tretinoin

Topics: Administration, Oral; Aged; Etretinate; Female; Foot Dermatoses; Hand Dermatoses; Humans; Psoriasis; Tretinoin

Topics: Administration, Oral; Adult; Foot Dermatoses; Foot Diseases; Humans; Isotretinoin; Keratoacanthoma; Male; Neoplasms, Multiple Primary; Skin Neoplasms; Tretinoin

Linear porokeratosis is a rare variant of porokeratosis of Mibelli and usually occurs in childhood. A 15-year-old boy is presented with typical clinical lesions of linear porokeratosis on the extensor surface of the right arm exhibiting the classical histopathologic criteria of the disease. Treatment with an oral aromatic retinoid resulted in a remission of the lesion.

Topics: Administration, Oral; Adolescent; Etretinate; Foot Dermatoses; Hand Dermatoses; Humans; Keratosis; Male; Syndrome; Tretinoin

2 patients with widespread porokeratosis Mibelli (PM) were treated orally with RO 10-9359. The dose was 75 mg/day for 10 days, then 50 mg/day for 3 weeks. The drug produced a good improvement of condition with no serious side effect. Ultrastructural examination of a healed lesion showed the presence of a fine granular substance in the intercellular space of the spinous layer, most likely produced by keratinocytes; ultrastructural cellular alterations of PM were still evident and the lesion recurred after suspension of treatment.

Topics: Aged; Etretinate; Foot Dermatoses; Hand Dermatoses; Humans; Keratosis; Male; Middle Aged; Skin; Syndrome; Tretinoin

Topics: Administration, Topical; Adult; Drug Evaluation; Female; Foot Dermatoses; Hand Dermatoses; Humans; Keratosis; Syndrome; Tretinoin; Vitamin A