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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Acitretin, Adult, Follow-Up Studies, HIV Infections, Humans, Male, Middle Aged, Pilot Projects, Psoriasis.
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Is acitretin therapy effective for psoriasis associated with human immunodeficiency virus infection? Context: To determine the safety, tolerability, and effectiveness of a newer retinoid, acitretin, as monotherapy for psoriasis associated with human immunodeficiency virus infection (PS-HIV). Pilot investigation. An academic medical center. Eleven patients selected from volunteers with PS-HIV were enrolled in a 20-week treatment protocol. Two patients discontinued participation in the study because of worsening psoriasis; a third patient was unable to continue treatment after having a myocardial infarction, presumably unrelated to acitretin therapy. Each patient received an optimized dose of acitretin during the period of observation. Clinical and laboratory assessments were performed every 2 weeks during the trial. The Psoriasis Area and Severity Index was used to assess the clinical response to treatment. To monitor for toxic drug effects, a panel of laboratory parameters, including complete blood cell count, biochemistry profile, urinalysis, HLA typing, skin biopsy for histological examination, and T-cell counts, was performed. Six (54%) of 11 patients with PS-HIV achieved good to excellent responses using acitretin monotherapy. Four patients (36%) achieved complete clearing. There was no evidence of a correlation between the pretreatment measures of immunosuppression and the therapeutic response. Parameters of immunosuppression were not exacerbated by acitretin therapy.
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Acitretin is a safe and effective treatment for PS-HIV. Both skin and joint manifestations of PS-HIV responded to acitretin therapy in most patients. Optimal results were achieved with a dose of 75 mg/d. The adverse effects were moderate and well tolerated. Acitretin does not appear to have immunosuppressive properties. A formal randomized clinical trial is warranted. Final Decision: yes