Etretinate therapy for papuloerythroderma

Papuloerythroderma, first reported by Ofuji et al. (1984), is a rare cutaneous disorder whose pathogenesis remains unknown. Owing to the small number of cases, there is no recommended choice of treatment. This is the first report on the efficacy of etretinate for papuloerythroderma. Seven male cases ranging in age from 65 to 84 years were treated with moderate doses (0.2-0.6 mg/kg/day) of etretinate. All but one case showed quick and excellent responses and the chronic recalcitrant erythrodermatous lesions disappeared within 2-5 weeks. Eventually all the seven cases could be brought into remission. Once remission was achieved, etretinate was tapered by 0.1-0.2 mg/kg/day over a period of 2-4 weeks. One case remained in complete remission after cessation of etretinate without any treatment for 16 months. Another case could stop etretinate treatment and the subsequent recurrence of papular eruption could be managed by topical steroids. In the other five cases remission could be maintained by daily doses of 0.16-0.36 mg/kg etretinate. None of the patients developed severe side effects. Our observation suggests that etretinate is a safe and effective agent for papuloerythroderma.