Acitretin has been associated with alopecia and hair shaft abnormalities such as hair kinking, hair curling, poliosis, and re-pigmentation of hair color. In the majority of patients, these side effects are dose-dependent, mild, and only temporary, with hair growth reoccurring after cessation of treatment. A 65-year-old male developed severe hair loss over his entire body seven weeks into treatment. He presented to us more than six months after discontinuation of acitretin without evidence of substantial hair regrowth. Here we report one of the rare cases of long-lasting alopecia after therapy with acitretin that we believe to be a case of generalized telogen effluvium.
VieiraA.V.SchneiderW.J.VieiraP.M.. Retinoids: transport, metabolism and mechanisms of action.J Endocrinol.1995. 146(2): 201–7.
2.
DograS.YadavS.. Acitretin in psoriasis: an evolving scenario.Int J Dermatol.2014. 53(5): 525–38.
3.
PearceD.J.KlingerS.ZielK.K.. Low-dose acitretin is associated with fewer adverse events than high-dose acitretin in the treatment of psoriasis.Arch Dermatol.2006. U2(8): 1000–4.
4.
PangM.L.MuraseJ.E.KooJ.. An updated review of acitretin – a systemic retinoid for the treatment of psoriasis.Expert Opin Drug Metab Toxicol2008. 4(7): 953–64.
5.
ChappellJ.A.ChuM.B.MartinK.HurleyM.Y.. Acitretin-induced poliosis with concurrent alopecia.J Drugs Dermatol.2012. 11(2): 247–9.
6.
LebwohlM.. Acitretin in combination with UVB or PUVA.J Am Acad Dermatol.1999. 41(3 Pt 2): S22–4.
7.
ClarkeJ.T.PriceH.ClarkeS.GeorgeR.MillerJ.J.. Acguired kinking of the hair caused by acitretin.J Drugs Dermatol.2007. 6(9): 937–8.
8.
WardP.D.MillerH.L.ShipmanA.R.. A case of repigmentation and curling of hair on acitretin therapy.Clin Exp Dermatol.2014. 39(1): 91–2.
9.
ChaveT.A.MortimerN.J.HutchinsonP.E.. Agranulocytosis and total scalp alopecia following acitretin.Br J Dermatol.2003. 148(5): 1063–4.
10.
OzluE.KaradagA.S.AkdenizN.UzuncakmakT.K.. Acitretin-induced alopecia areata: a case report.Cutan Ocul Toxicol.2015. 34(3): 248–50.
11.
GaudielloF.ScalvenziM.GalloL.BalatoN.. Excess granulation tissue and hair loss following acitretin.Dermatol Reports.2011. 3(1): e2.
12.
Berth-JonesJ.ShuttleworthD.HutchinsonP.E.. A study of etretinate alopecia.Br J Dermatol.1990. 122(6): 751–5.
13.
FoitzikK.SpexardT.NakamuraM.HalsnerU.PausR.. Towards dissecting the pathogenesis of retinoid-induced hair loss: all-trans retinoic acid induces premature hair follicle regression (catagen) by upregulation of transforming growth factor-beta2 in the dermal papilla.J Invest Dermatol.2005. 124(6): 1119–26.
