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Hepatotoxic Reactions in a Patient Treated With Etretinate

Virginia C. Weiss, MD; Dennis P. West, MS; Rollie Ackerman, MD; Lisa A. Robinson
[+] Author Affiliations

Accepted for publication Dec 24, 1982.

Reprint requests to Department of Dermatology, University of Illinois, PO Box 6998, Chicago, IL 60680 (Dr Weiss).


From the Department of Dermatology, College of Medicine (Drs Weiss and Ackerman and Mr West), and the Department of Pharmacy Practice, College of Pharmacy (Mr West and Ms Robinson), University of Illinois at Chicago.


Arch Dermatol. 1984;120(1):104-106. doi:10.1001/archderm.1984.01650370110022
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• Hepatotoxic reactions and eosinophilia developed in a 74-year-old woman who had been treated with an aromatic retinoid compound, etretinate, for severe psoriasis palmaris et plantaris. Rapid improvement in her condition followed discontinuation of the drug therapy. Liver enzyme elevations recurred after reinstitution of etretinate therapy; these levels quickly returned to normal after the drug therapy was again discontinued. Our patient's reaction to etretinate may have been a hypersensitivity reaction.

(Arch Dermatol 1984;120:104-106)

REFERENCES

Elias PM, Williams ML:  Retinoids, cancer, and the skin . Arch Dermatol 1981;;117:160-180.
Fritsch P:  Oral retinoids in dermatology . Int J Dermatol 1981;;20:314-329.
Russell RM, Boyer JL, Bagheri SA, et al:  Hepatic injury from chronic hypervitaminosis A resulting in portal hypertension and ascites . N Engl J Med 1974;;291:435-440.
Muenter MD, Perry HO, Ludwig J:  Chronic vitamin A intoxication in adults: Hepatic, neurologic and dermatologic complications . Am J Med 1971;;50:129-136.
Hänni R:  Pharmacokinetic and metabolic pathways of systemically applied retinoids . Dermatologica 1978;;157( (suppl 1) ):5-10.
Paravicini U, Stöckel K, MacNamara PJ, et al:  On metabolism and pharmacokinetics of an aromatic retinoid . Ann NY Acad Sci 1981;;359:54-67.
Brazzel RK, Colburn WA:  Pharmacokinetics of the retinoids isotretinoin and etretinate . J Am Acad Dermatol 1982;;6( (suppl) ):643-651.
Goerz G, Orfanos CE:  Systemic treatment of psoriasis with a new aromatic retinoid: Preliminary evaluation of a multicenter controlled study in the Federal Republic of Germany . Dermatolog- ica 1978;;157( (suppl 1) ):38-44.
Orfanos CE, Marhle G, Goerz G, et al:  Laboratory investigations in patients with generalized psoriasis under oral retinoid treatment: A multicenter study of computerized data . Dermatologica 1979;;159:62-70.
Fredriksson T:  Oral treatment of psoriasis and pustulosis palmoplantaris with RO 10-9359 . Dermatologica 1978;;157( (suppl 1) ):13-18.
Thune P, Mork NJ:  A case of centrolobular toxic necrosis of the liver due to aromatic retinoid: Tigason (RO 10-9359) . Dermatologica 1980;;160:405-408.
Glazer S, Sparberg M, Yakoo H, et al:  RO 10-9359 in psoriasis: Study of effectiveness and potential hepatotoxicity . J Invest Dermatol 1981;;76:303.
Glazer SD, Roenigk HH, Yakoo H, et al:  A study of potential hepatotoxicity of etretinate used in the treatment of psoriasis . J Am Acad Dermatol 1982;;6( (suppl) ):683-687.
Mitchell JR, Lauterberg BH:  Drug-induced liver injury . Hosp Pract 1978;;13:95-98, 103-106.
Schaffner F, Popper H:  Adverse drug reactions involving the liver: Probable mechanisms . Mt Sinai J Med 1977;;44:813-819.

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Elias PM, Williams ML:  Retinoids, cancer, and the skin . Arch Dermatol 1981;;117:160-180.
Fritsch P:  Oral retinoids in dermatology . Int J Dermatol 1981;;20:314-329.
Russell RM, Boyer JL, Bagheri SA, et al:  Hepatic injury from chronic hypervitaminosis A resulting in portal hypertension and ascites . N Engl J Med 1974;;291:435-440.
Muenter MD, Perry HO, Ludwig J:  Chronic vitamin A intoxication in adults: Hepatic, neurologic and dermatologic complications . Am J Med 1971;;50:129-136.
Hänni R:  Pharmacokinetic and metabolic pathways of systemically applied retinoids . Dermatologica 1978;;157( (suppl 1) ):5-10.
Paravicini U, Stöckel K, MacNamara PJ, et al:  On metabolism and pharmacokinetics of an aromatic retinoid . Ann NY Acad Sci 1981;;359:54-67.
Brazzel RK, Colburn WA:  Pharmacokinetics of the retinoids isotretinoin and etretinate . J Am Acad Dermatol 1982;;6( (suppl) ):643-651.
Goerz G, Orfanos CE:  Systemic treatment of psoriasis with a new aromatic retinoid: Preliminary evaluation of a multicenter controlled study in the Federal Republic of Germany . Dermatolog- ica 1978;;157( (suppl 1) ):38-44.
Orfanos CE, Marhle G, Goerz G, et al:  Laboratory investigations in patients with generalized psoriasis under oral retinoid treatment: A multicenter study of computerized data . Dermatologica 1979;;159:62-70.
Fredriksson T:  Oral treatment of psoriasis and pustulosis palmoplantaris with RO 10-9359 . Dermatologica 1978;;157( (suppl 1) ):13-18.
Thune P, Mork NJ:  A case of centrolobular toxic necrosis of the liver due to aromatic retinoid: Tigason (RO 10-9359) . Dermatologica 1980;;160:405-408.
Glazer S, Sparberg M, Yakoo H, et al:  RO 10-9359 in psoriasis: Study of effectiveness and potential hepatotoxicity . J Invest Dermatol 1981;;76:303.
Glazer SD, Roenigk HH, Yakoo H, et al:  A study of potential hepatotoxicity of etretinate used in the treatment of psoriasis . J Am Acad Dermatol 1982;;6( (suppl) ):683-687.
Mitchell JR, Lauterberg BH:  Drug-induced liver injury . Hosp Pract 1978;;13:95-98, 103-106.
Schaffner F, Popper H:  Adverse drug reactions involving the liver: Probable mechanisms . Mt Sinai J Med 1977;;44:813-819.

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