Acitretin therapy is effective for psoriasis associated with human immunodeficiency virus infection.

Abstract

OBJECTIVE:

To determine the safety, tolerability, and effectiveness of a newer retinoid, acitretin, as monotherapy for psoriasis associated with human immunodeficiency virus infection (PS-HIV).

DESIGN:

Pilot investigation.

SETTING:

An academic medical center.

PATIENTS:

Eleven patients selected from volunteers with PS-HIV were enrolled in a 20-week treatment protocol. Two patients discontinued participation in the study because of worsening psoriasis; a third patient was unable to continue treatment after having a myocardial infarction, presumably unrelated to acitretin therapy.

INTERVENTION:

Each patient received an optimized dose of acitretin during the period of observation. Clinical and laboratory assessments were performed every 2 weeks during the trial.

MAIN OUTCOME MEASURES:

The Psoriasis Area and Severity Index was used to assess the clinical response to treatment. To monitor for toxic drug effects, a panel of laboratory parameters, including complete blood cell count, biochemistry profile, urinalysis, HLA typing, skin biopsy for histological examination, and T-cell counts, was performed.

RESULTS:

Six (54%) of 11 patients with PS-HIV achieved good to excellent responses using acitretin monotherapy. Four patients (36%) achieved complete clearing. There was no evidence of a correlation between the pretreatment measures of immunosuppression and the therapeutic response. Parameters of immunosuppression were not exacerbated by acitretin therapy.

CONCLUSIONS:

Acitretin is a safe and effective treatment for PS-HIV. Both skin and joint manifestations of PS-HIV responded to acitretin therapy in most patients. Optimal results were achieved with a dose of 75 mg/d. The adverse effects were moderate and well tolerated. Acitretin does not appear to have immunosuppressive properties. A formal randomized clinical trial is warranted.

• Authors: L Buccheri, B R Katchen, A J Karter, S R Cohen
• Journal: Archives of dermatology (Arch Dermatol) Vol. 133 Issue 6 Pg. 711-5 (Jun 1997) ISSN: 0003-987X [Print] United States
• PMID: 9197824 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Acitretin

Topics

• Acitretin (therapeutic use)
• Adult
• Follow-Up Studies
• HIV Infections (complications)
• Humans
• Male
• Middle Aged
• Pilot Projects
• Psoriasis (complications, drug therapy)