• Biomolecules & Therapeutics
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• v.30 no.6
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• pp.562-569
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• 2022

Etretinate, an acitretin metabolite, has a long retention duration in adipose tissues with a teratogenic potential. FDA advises a contraceptive period of at least three years after discontinuing acitretin. However, the effect of accumulated etretinate in adipose tissues on fetus is unknown. Although the teratogenic threshold for serum concentration of etretinate has been presented as higher than 2 ng/mL, that of acitretin is unknown. To examine factors affecting body retention of acitretin and etretinate, effects of acitretin dosage, acitretin-taking duration, elapsed time after stopping acitretin, age, sex, concomitant alcohol consumption, and foods and supplements rich in vitamin A intake on serum concentrations of acitretin and etretinate were analyzed in 14 acitretin-taken patients and 58 controls without taking acitretin or etretinate. Serum concentrations of acitretin, but not etretinate, tended to be inversely related to the discontinuation duration. They were also related to old age. Different from a published result that alcohol consumption could promote the metabolism of acitretin into etretinate, alcohol intake did not affect serum concentrations of etretinate. Unexpectedly, more frequent intake of vitamin A or provitamin A-rich food and supplements was associated with higher serum acitretin, whereas less frequent intake of vitamin A or provitamin A-rich food and supplements was associated with higher serum levels of etretinate in acitretin-taken patients. Despite preliminary data, inter-individual variations in serum retention of etretinate suggest the necessity of further research before applying the same guidelines to everyone to minimize unnecessary contraception.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.3
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• pp.74-98
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• 2023

Objectives : This study aims to evaluate the add-on effect of herbal bath combined with acitretin in patients with psoriasis. Methods : We searched randomized controlled trials(RCTs) reporting the effect of herbal bath and acitretin combined treatment for psoriasis in 10 electronic databases from their inception to January 2023. Study collection, data extraction, and risk of bias assessment were performed by two independent researchers. Data synthesis and risk of bias evaluation was conducted using Revman 5.4. Results : Ten RCTs with 1,008 subjects were included. Herbal bath and acitretin combined treatment group showed higher average total effective rate than acitretin alone group(RR 1.39; 95% CI: 1.15-1.68, P=0.0006, I² =0%). Herbal bath and additional treatments such as phototherapy(NB-UVB) and oral herbal medicine, combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.81; 95% CI: 1.47-2.22, P<0.00001, I² =43%). Herbal bath and phototherapy(NB-UVB) combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.51; 95% CI: 1.18-1.93, P=0.0009, I² =0%). The overall risk of bias of the included studies was unclear or of high risks. Conclusions : This review showed that the add-on of herbal bath combined with acitretin treatment could be more effective than acitretin alone treatment in patients with psoriasis. However, because of few included studies, heterogeneity between studies, and insufficient quality of included studies, further well-designed RCTs are needed to confirm the add-on effect of herbal bath on psoriasis.

• Journal of Life Science
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• v.19 no.3
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• pp.327-333
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• 2009

Psoriasis is a well known disorder of keratinization. In this disease, several reports revealed that dermal micro vessels are increased and angiogenic factors such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) are over-expressed. Angiogenesis may play an important role in the progression of psoriasis. Acitretin is widely used as an anti-psoriatic drug because of its potent action on keratinocyte growth and differentiation, but its effects on angiogenesis are uncertain. The goal of this immunohistochemical study was to investigate the effects of acitretin on the expression of VEGF in psoriatic lesions of the skin. We compared the expression levels of VEGF between pre- and post-acitretin treated skin - 10 psoriatic skin lesions and 3 normal (control) skins. The expressions of VEGF in psoriatic skin lesions were significantly higher than in normal control skin. The expressions of VEGF in psoriatic skin lesions post-treatment were lower than those pre-treatment. Acitretin revealed inhibitory effects on angiogenesis by reducing the expression of angiogenic factors such as VEGF in psoriatic skin lesions. We suggest that acitretin may be useful in therapeutic approaches to psoriasis management, possibly related to angiogenesis.

• Journal of Veterinary Clinics
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• v.37 no.6
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• pp.339-341
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• 2020

Subcorneal pustular dermatosis (SPD) is a rare pustular skin disorder of dogs. Dapsone is treatment of choice, but ineffective in some cases. Therapeutic alternatives are limited and less effective. In humans, successful results with oral retinoid have been reported. To describe successful treatment of a dog that developed SPD with acitretin as an alternative drug of dapsone. A 7-year-old male neutered miniature schnauzer was presented with generalized pustules and crusts. SPD was diagnosed based on physical, cytological, and histopathological examination with direct immunofluorescence test. In this report, we describe a case of canine SPD treated initially by dapsone with poor response that improved with acitretin. Acitretin could be considered as an alternative drug in canine SPD.

• Korean journal of dermatology
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• v.56 no.10
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• pp.658-659
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• 2018