Title: Oral Alitretinoin in Congenital Ichthyosis: A Pilot Study Shows Variable Effects and a Risk of Central Hypothyroidism
Abstract: Congenital ichthyosis is a large group of hereditary skin disorders with different aetiologies, all of which are pre-sent at birth (1). The patients have dry, widespread scaling and thickened skin (2). At present there is no cure for ichthyosis and therapy is mostly symptomatic. Life-long treatment with emollients is essential, and some patients also use systemic therapy with retinoids, especially aci-tretin (3). The most serious adverse effect of retinoids is teratogenicity, which is a special concern for acitretin as it is excreted from the body slowly (3).Alitretinoin (9-cis retinoic acid) is a fairly new oral retinoid with more rapid clearance than acitretin. In contrast to acitretin and isotretinoin, alitretinoin binds to both types of nuclear retinoid receptors, retinoic acid receptors (RARs) and retinoid X receptors (RXRs). It is indicated for chronic hand eczema in most European countries and has been found to be well-tolerated (4). We report here our preliminary experiences from an uncontrolled study of alitretinoin in 4 patients with congenital ichthyosis. PATIENTS AND METHODS