• 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