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Etretinate therapy for generalized pustular psoriasis in children
Insights
Etretinate therapy effectively treated severe pustular psoriasis in two young children over 3.5 years. The treatment showed significant improvement in skin condition without negatively impacting growth and development.
Area of Science:
- Dermatology
- Pediatric Medicine
- Pharmacology
Background:
- Pustular psoriasis is a severe skin condition that can be debilitating in children.
- Limited treatment options exist for recalcitrant pediatric pustular psoriasis.
- Etretinate is a retinoid with potential therapeutic benefits for severe dermatological conditions.
Observation:
- Two young children (19 months old) with severe, recalcitrant pustular psoriasis were treated with etretinate.
- Treatment was administered intermittently over a 3.5-year period.
- Comprehensive monitoring included laboratory tests, spinal roentgenograms, and bone age assessments.
Findings:
- Both children experienced remarkable improvement in their pustular psoriasis.
- No apparent adverse effects on growth and development were observed.
- Transient, mild side effects included dry skin, skin fragility, and minor elevations in liver enzymes and triglycerides.
Implications:
- Etretinate therapy presents a viable treatment option for pediatric intractable pustular psoriasis.
- This approach may significantly improve the quality of life for affected children.
- Further research into long-term efficacy and safety in pediatric populations is warranted.
Abstract:
Two children, 19 months of age, were independently treated with a compassionate protocol of etretinate therapy for recalcitrant, debilitating pustular psoriasis. Laboratory test results, roentgenograms of the spine, and bone age were periodically monitored. Over a 31/2-year period of intermittent treatment with a maximum dosage of 1.5 mg/kg/d, both children showed remarkable improvement with no apparent drug effect on growth and development. Side effects included xerosis, skin fragility and transient, minimal elevations of aspartate aminotransferase, lactic dehydrogenase, and triglyceride levels. Etretinate therapy may prove to be a viable treatment option for the child with intractable pustular psoriasis that seriously impairs quality of life.