ABSTRACT
Acitretin is a systemic, second-generation monoaromatic retinoid and synthetic derivative of vitamin A. Potential adverse effects of acitretin are generally dose-dependent and related to hypervitaminosis A, including elevated serum lipids and liver enzymes, mucocutaneous cheilitis, dryness, peeling, pruritis, and rarely hypoglycemia, depression, or hepatotoxicity. Acitretin is highly teratogenic, which makes inadvisable its use in women who are pregnant or intend to become pregnant. Due to its significant adverse effects, acitretin is reserved for use as second-line therapy to treat severe psoriasis and other keratinizing disorders that are unresponsive or intolerant to standard therapy. Acitretin's mechanism of action has not been fully elucidated; however, it is known to have antiproliferative, anti-inflammatory, and anti-angiogenic effects. Acitretin continues to play a significant role in the management of resistant psoriasis and other keratinizing disorders. Many of the reported cellular effects of acitretin are highly dependent on cell type, microenvironment, and experimental model.
