Ulcerated atrophic striae from etretinate

Oral retinoids such as etretinate and acitretin are commonly associated with dose-dependent, mucocutaneous side effects such as dryness, peeling, and fragility. Although these effects can be extreme in some patients and even require discontinuation of treatment, thinning of skin to the point of atrophy and ulceration has never been reported in the English literature. We present the case of a patient with psoriasis in whom ulcerated atrophic striae developed during etretinate therapy. After discontinuation of etretinate, all cutaneous ulcers resolved. Subsequently, the patient had a favorable response to oral calcitriol (1,25-dihydroxy vitamin D3), a novel therapy for psoriasis.