Vito Di Lernia1, Domenico Bonamonte2, Claudia Lasagni3, Anna Belloni Fortina4, Stefano Cambiaghi5, Monica Corazza6, Sergio Di Nuzzo7, Paolo Gisondi8, Michele Panzone9, Claudio Guarneri10, Iria Neri11. 1. Dermatology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. vito.dilernia@asmn.re.it. 2. Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy. 3. Dermatology Unit, Department of Head and Neck Surgery, University of Modena, Modena, Italy. 4. Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy. 5. UOC Dermatologia Pediatrica, Ospedale Maggiore, Policlinic of Milan, Milan, Italy. 6. Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy. 7. Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University Hospital, Parma, Italy. 8. Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy. 9. Department of Dermatology, University of Turin, Turin, Italy. 10. Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy. 11. Division of Dermatology, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Abstract
BACKGROUND: Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis. METHODS: Retrospective analysis of a group of children and adolescents (<17 years of age) with moderate to severe plaque psoriasis treated with acitretin between 2010 and 2014 at Italian dermatology clinics. Patients were identified through databases or registries. RESULTS: The study population consisted of 18 patients with a median age of 9.5 years at the start of therapy. The median maintenance dosage per day was 0.41 mg/kg. Eight patients (44.4%) achieved complete clearance or good improvement of their psoriasis, defined as improvement from baseline of 75% or more on the Psoriasis Area and Severity Index at week 16. Three had three or more courses of treatment with short disease-free intervals. In three patients, acitretin treatment was ongoing at the time of data collection. The mean total duration of treatment in responders was 22.7 months. One patient discontinued treatment because of arthralgia. The remaining nine patients (50%) discontinued treatment because it was ineffective. Mucocutaneous adverse effects occurred in all patients, but did not affect therapy maintenance. CONCLUSIONS: In this retrospective case series, acitretin was a moderately effective, well-tolerated treatment in children with moderate to severe plaque psoriasis. Given the small number of patients, statements about long-term safety are not possible.
BACKGROUND: Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis. METHODS: Retrospective analysis of a group of children and adolescents (<17 years of age) with moderate to severe plaque psoriasis treated with acitretin between 2010 and 2014 at Italian dermatology clinics. Patients were identified through databases or registries. RESULTS: The study population consisted of 18 patients with a median age of 9.5 years at the start of therapy. The median maintenance dosage per day was 0.41 mg/kg. Eight patients (44.4%) achieved complete clearance or good improvement of their psoriasis, defined as improvement from baseline of 75% or more on the Psoriasis Area and Severity Index at week 16. Three had three or more courses of treatment with short disease-free intervals. In three patients, acitretin treatment was ongoing at the time of data collection. The mean total duration of treatment in responders was 22.7 months. One patient discontinued treatment because of arthralgia. The remaining nine patients (50%) discontinued treatment because it was ineffective. Mucocutaneous adverse effects occurred in all patients, but did not affect therapy maintenance. CONCLUSIONS: In this retrospective case series, acitretin was a moderately effective, well-tolerated treatment in children with moderate to severe plaque psoriasis. Given the small number of patients, statements about long-term safety are not possible.
Authors: Inge M G J Bronckers; Marieke M B Seyger; Dennis P West; Irene Lara-Corrales; Megha Tollefson; Wynnis L Tom; Marcia Hogeling; Leah Belazarian; Claus Zachariae; Emmanuel Mahé; Elaine Siegfried; Sandra Philipp; Zsuzsanna Szalai; Ruth Ann Vleugels; Kristen Holland; Ruth Murphy; Eulalia Baselga; Kelly Cordoro; Jo Lambert; Alex Alexopoulos; Ulrich Mrowietz; Wietske Kievit; Amy S Paller Journal: JAMA Dermatol Date: 2017-11-01 Impact factor: 10.282
Authors: D Thaçi; K Papp; D Marcoux; L Weibel; A Pinter; P-D Ghislain; I Landells; P H Hoeger; K Unnebrink; M M B Seyger; D A Williams; S Rubant; S Philipp Journal: Br J Dermatol Date: 2019-07-25 Impact factor: 9.302
Authors: Andrea L Zaenglein; Moise L Levy; Nicole S Stefanko; Latanya T Benjamin; Anna L Bruckner; Keith Choate; Brittany G Craiglow; John J DiGiovanna; Lawrence F Eichenfield; Peter Elias; Philip Fleckman; Leslie P Lawley; Richard A Lewis; Anne W Lucky; Erin F Mathes; Leonard M Milstone; Amy S Paller; Sonali S Patel; Dawn H Siegel; Joyce Teng; Sherry A Tanumihardjo; Lauren Thaxton; Mary L Williams Journal: Pediatr Dermatol Date: 2020-11-10 Impact factor: 1.588