Etretinate (Tigason) hepatitis in 2 patients

Area of Science:

• Hepatology
• Dermatology
• Toxicology

Background:

• Etretinate is a retinoid medication used for dermatological conditions.
• Hepatitis is a significant potential side effect of certain medications.
• Understanding drug-induced liver injury is crucial for patient safety.

Observation:

• Two patients, one with psoriasis and one with basal cell nevus syndrome, developed hepatitis shortly after starting etretinate.
• No other causes for hepatitis were identified in these patients.
• Hepatitis recurred or persisted upon re-administration of etretinate.

Findings:

• The clinical and histological evidence strongly suggests etretinate as the causative agent for hepatitis in both patients.
• The observed hepatitis was reversible upon discontinuation of etretinate.
• The basal cell nevus syndrome patient tolerated 13-cis-retinoic acid without liver test abnormalities.

Implications:

• Etretinate should be used cautiously in patients with underlying liver conditions or risk factors.
• Hepatitis should be monitored in patients undergoing etretinate therapy.
• 13-cis-retinoic acid may represent a safer alternative for patients sensitive to etretinate regarding hepatotoxicity.