Low dose acitretin in the treatment of plaque type psoriasis: descriptive study of efficacy and safety

We retrospectively evaluated efficacy and safety of acitretin in a cohort of 46 patients affected with moderate to severe plaque psoriasis. Patients were treated at an initial dose of 10 mg/day, then gradually increased until reaching the best therapeutic effect with the fewest adverse effects (<50 mg/day) and later decreased and maintained at the lowest effective dosage. Efficacy measures were: i) PASI75 between 10 and 16 weeks, ii) PASI50, iii) PASI75 even after 16 weeks of treatment. At week 10-16 PASI75 was achieved by 47.8% of patients and 87% achieved PASI50. Overall, 67.3% reached PASI75. Adverse events occurred in 18 patients (39.1%); among these, 4 (8.7%) discontinued acitretin. Our findings suggest that acitretin at an initial low, gradually escalating dose, then maintained at the minimal effective dose, is a suitable treatment option for plaque psoriasis as it provides clearing in most treated patients while minimizing the risks of side effects.