Alitretinoin reduces erythema in inherited ichthyosis

Abstract

BackgroundAcitretin 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.ResultsA 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.ConclusionsAlitretinoin may be suitable for hereditary ichthyosis with prominent erythema, especially for women of childbearing age.

Safe and effective use of alitretinoin in children with recalcitrant hand eczema and other dermatoses – a retrospective analysis

“…This adds to the increasing body of literature showing that alitretinoin may be beneficial for patients with other inflammatory dermatoses. Moderate efficacy of alitretinoin in ARCI was demonstrated before …”

“…To the best of our knowledge, there is one single report on the use of alitretinoin in an adolescent patient . This is noteworthy as alitretinoin might have a number of potential advantages over other systemic medications used in paediatric dermatology.…”

“…However, we treated an adult NS patient with alitretinoin at our institution and recorded a 50–75% improvement of her skin findings with sustained efficacy over the whole 3‐year treatment period (unpublished data). Positive experiences with alitretinoin in patients with NS were also reported in the literature …”

“…Experience with this medication in childhood and adolescence is very limited. Currently, there is only one report on the use of alitretinoin in an adolescent patient with netherton syndrome …”

Management of congenital ichthyoses: European guidelines of care, part one

“…There is no proper comparative study with acitretin. Alitretinoin has been reported as effective in reducing erythema in a small series of patients with CI and some case reports . Efficacy on scaling was reported for a few patients at a high dose .…”