Acitretin therapy is effective for associated with human immunodeficiency virus infection

Laura Buccheri, Bradford R. Katchen, Andrew J. Karter, Steven R. Cohen

Research output: Contribution to journalArticle

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Abstract

Objective: To determine the safety, tolerability, and effectiveness of a newer retinoid, acitretin, as mono-therapy 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 mono-therapy. 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.

Original languageEnglish (US)
Pages (from-to)711-715
Number of pages5
JournalArchives of Dermatology
Volume133
Issue number6
StatePublished - 1997

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Acitretin
Virus Diseases
HIV
Psoriasis
Therapeutics
Blood Cell Count
Immunosuppression
Skin Manifestations
Patient Participation
Histocompatibility Testing
Urinalysis
Poisons
Retinoids
Immunosuppressive Agents
Clinical Protocols
Biochemistry
Volunteers
Randomized Controlled Trials
Cell Count
Joints

ASJC Scopus subject areas

  • Dermatology

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Acitretin therapy is effective for associated with human immunodeficiency virus infection. / Buccheri, Laura; Katchen, Bradford R.; Karter, Andrew J.; Cohen, Steven R.

In: Archives of Dermatology, Vol. 133, No. 6, 1997, p. 711-715.

Research output: Contribution to journalArticle

Buccheri, Laura ; Katchen, Bradford R. ; Karter, Andrew J. ; Cohen, Steven R. / Acitretin therapy is effective for associated with human immunodeficiency virus infection. In: Archives of Dermatology. 1997 ; Vol. 133, No. 6. pp. 711-715.
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abstract = "Objective: To determine the safety, tolerability, and effectiveness of a newer retinoid, acitretin, as mono-therapy 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 mono-therapy. 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.",
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