Clinical cases

Introduction: Psoriasis is defined as a chronic inflammatory disease, with an immunologically mediated etiology and the involvement of hereditary factors, with cutaneous and joint manifestations and rare mucosal implication. Psoriasis affects 2–4% of the population and can have an onset at any age, with peaks at 15–25 years and 50–60 years. It tends to persist lifelong, fluctuating in extent and severity and has a profound emotional and social impact on patients.
Patients and Methods: We present 2 cases of psoriasis patients with prolonged acitretin treatment, with doses of 30mg/day and 75-90mg/day respectively. The patients presented with rare side-effects, in the case of the first patient treatment induced onycholysis, as well as common side-effects, hyperlipidemia in the case of the second patient.
Discussions: The treatment course of the 2 patients led to improvement of both clinical aspects and PASI scores. However, the side-effects that appeared during Acitretin therapy required the reevaluation of the treatment regimen, including introduction of associated hypolipidemic treatement and considering alternative solutions.
Conclusions: Retinoids can be a useful therapy provided there is a permanent monitoring of the patient’s biological functions. The use of low dose therapy (25- 30mg/day) for prolonged regimens is advisable, this particular strategy yielding favourable results with minimal side-effects.