Acitretin in psoriasis: an overview of adverse effects

J Am Acad Dermatol. 1999 Sep;41(3 Pt 2):S7-S12. doi: 10.1016/s0190-9622(99)70359-2.


Oral retinoids are among the drugs of choice for pustular and erythrodermic psoriasis. In addition, retinoids are effective in combination with other topical and systemic agents for the treatment of plaque-type psoriasis. Acitretin, the active retinoid metabolite, has replaced etretinate in retinoid therapy of psoriasis because of its more favorable pharmacokinetic profile, including a significantly shorter half-life. Retinoids, including acitretin, are potent teratogens, leading to strict requirements for pregnancy prevention during and after their use. Other retinoid side effects are generally preventable or manageable through proper patient selection, dose adjustments, and routine monitoring. Mucocutaneous side effects such as cheilitis and hair loss are the most common dose-dependent side effects, requiring dose reduction in some patients. Less common effects such as hepatotoxicity, serum lipid alterations, pancreatitis, and possible skeletal effects are also discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Abnormalities, Drug-Induced / prevention & control
  • Acitretin / adverse effects*
  • Acitretin / metabolism
  • Drug Interactions
  • Etretinate / metabolism
  • Eye Diseases / chemically induced
  • Female
  • Humans
  • Hyperlipidemias / chemically induced
  • Hyperostosis / chemically induced
  • Keratolytic Agents / adverse effects*
  • Keratolytic Agents / metabolism
  • Liver / drug effects
  • Male
  • Mucous Membrane / drug effects
  • Pancreatitis / chemically induced
  • Pseudotumor Cerebri / chemically induced
  • Skin Diseases / chemically induced


  • Keratolytic Agents
  • Etretinate
  • Acitretin