Long‐term safety and efficacy of continuous acitretin monotherapy for three children with different severe hyperkeratotic disorders in China

Abstract

Long-term systemic treatment with acitretin for severe hyperkeratotic disorders is needed to maintain quality of life of afflicted patients, but treatment has been limited owing to its potential side-effects including skeletal malformations, particularly for children during their growth and development. A retrospective investigation was conducted with three children afflicted with a severe hyperkeratotic disorder, namely Darier's disease, bullous ichthyosiform erythroderma or lamellar ichthyosis, who were continuously maintained on 0.2-0.3 mg/kg per day acitretin for more than 12 years after an initial period at a larger acitretin dose to bring each disease under control. The patients had good responses to acitretin treatment, which was assessed for safety, skeletal abnormalities, growth retardation and other potential side-effects. Acitretin monotherapy was an effective treatment for these children, and maintenance doses were well tolerated with no skeletal or other observable side-effects during the course of the study.

Successful clearance of extensive/recalcitrant cutaneous warts by acitretin monotherapy: A case series study

“…Several studies observed that the patients in whom the treatment of retinoids was stopped too early/fast or the cumulative dose was too low showed an increased chance of wart recurrence and a decreased response to treatment 20,41,42 . In agreement with our previous studies on children with pustular psoriasis treated with acitretin ≤1 mg kg −1 day −1 for 3 months 43 and children with different severe hyperkeratotic disorders treated with acitretin 0.2‐0.3 mg kg −1 day −1 for more than 12 years, 44 no significant side effects were reported during the treatment and follow‐up of acitretin monotherapy apart from mild cheilitis, skin and mouth dryness, hair loss, and a slight increase in lipid levels in our study.…”

Successful Darier disease treatment in Russian patients

“…For instance, the initial dose of acitretin is 10 to 25 mg/day. 4,5 Provided no side effects are observed, the dose of acitretin can be gradually increased up to 60 mg/day within 2 months. After the lesions resolve, the dose of the remedy can be gradually reduced.…”

“…After the lesions resolve, the dose of the remedy can be gradually reduced. 4,6 T A B L E 1 Darier disease treatment…”

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

“…While there is no previously reported experience with the use of alitretinoin in children, systemic isotretinoin and acitretin have been prescribed for decades in paediatric dermatology for a number of dermatoses and prolonged treatment up to many years is regularly performed . Acitretin is even used in neonates with severe disorders of cornification such as harlequin‐ichthyosis .…”