Description

Acitretin is an oral retinoid (vitamin-A derivative) used to treat severe psoriasis, usually at a dose of 0.*5 1 mg per kg body weight per day. It is best taken after a meal because it needs fat to be absorbed through the gut wall.

Acitretin is available as *0 mg and *5 mg capsules. Trade names include Neotigason™ and Novatretin®. Since March ***9, PHARMAC funding in New Zealand requires Special Authority application by a dermatologist or vocationally registered general practitioner. Restrictions apply.

Acitretin is particularly effective for pustular psoriasis, erythrodermic psoriasis and psoriasis affecting hands and feet. It is not effective for psoriatic arthritis.

It is occasionally used to treat other skin conditions including:
 

It is occasionally used to treat other skin conditions including:

• Palmoplantar pustulosis
• Hand dermatitis (when very thick and scaly)
• Darier disease
• Lichen planus
• Lichen sclerosus
• Lupus erythematosus
• Cutaneous T-cell lymphoma
• Extensive granuloma annulare
• Severe ichthyosis
• Extensive actinic keratoses and skin cancers
• Extensive  warts

Acitretin is thought to work in psoriasis by slowing down the proliferation of the skin cells. A response is noted in more than half of treated patients. Improvement begins about two weeks after starting treatment, and is maximum after about twelve weeks. The affected skin either peels off or gradually clears.

Some patients are treated with acitretin for a few months, repeated from time to time, whilst others remain on the acitretin long term.

In resistant cases, acitretin can be combined with other antipsoriatic drugs and/or phototherapy.