Acitretin

Acitretin, an aromatic retinoid, was primarily used for treating pustular psoriasis and psoriatic palmo-plantar keratoderma, with combination therapies needed for other psoriasis forms. It was also effective for keratinization disorders and severe lichen planus. The drug had a terminal elimination half-life of 55-60 hours, but alcohol intake could extend this to 84-168 days due to conversion to etretinate. Acitretin was a potent teratogen, necessitating contraception during and 2 years post-therapy. Side effects included mucocutaneous issues (e.g., hair loss), elevated transaminases in 5-8% of patients, hyperlipidemia, and rare acute hepatotoxic reactions. Bony changes were reported, and growth monitoring was essential in children. Combining acitretin with hepatotoxic drugs or cyclines was contraindicated.