Psoriasis
- Approved by the FDA for use in psoriasis in 1997
- Used in monotherapy to treat generalized pustular, localized pustular and erythrodermic psoriasis
- More effective at treating severe plaque-type psoriasis when used in combination with other treatments
Off-Label Uses
- Darier’s disease
- Ichthyosiform erythroderma
- Lamellar ichthyosis
- Erythrokeratoderma variabilis
- Lichen planus
- Sjogren-Larsson Syndrome
- Pityriasis rubra pilaris
- Palmoplantar pustulosis
- Post-transplantation: to reduce squamous cell carcinomas
See details on indications for Off-label uses below
Darier’s Disease
- Most effective when treating widespread hyperkeratotic forms of Darier’s disease
- Episodic use is prudent, particularly in months when a flare-up is expected
- Lower starting dose of 0.2-0.3 mg/kg/day may prevent the initial flare-up commonly seen with patients treated with retinoids
Lamellar ichthyosis
- Good response often seen at 0.5-1 mg/kg/day, with significant response seen during the first 2 months of therapy
- Maintenance dose can be reduced to 25 mg/day
Erythrokeratoderma variabilis
- Patients should be started at low doses with a gradual dosage increase to avoid a flare-up in the number of erosions or bullae
Lichen planus
- Therapy of 30 mg/day for 8 weeks showed remission or marked improvements in 64% of patients in a double-blind placebo-controlled study
- Most effective when combined with a systemic corticosteroid to control severe cases
Pityriasis rubra pilaris
- The use of acitretin has not been reported, although it is assumed that it is effective when given within a dose range of 1 mg/kg/day
