Successful Management of Psoriasis with SORIATANE® (acitretin)

Sarah’s Struggle with Psoriasis

Sarah had a history of psoriasis for the past two years. She tried various treatments, including topical corticosteroids and phototherapy, with limited success.

Sarah presented to my clinic with complaints of worsening psoriasis plaques on her elbows, knees, and scalp. She reported significant itching, discomfort, and self-consciousness due to the visible nature of her condition. She expressed frustration with previous treatments' lack of efficacy and desired a more effective solution.

Upon examination, Sarah showed extensive erythematous, scaly plaques consistent with her elbows, knees, and scalp psoriasis. Her PASI (Psoriasis Area Severity Index) score was calculated to be 20.5, indicating severe disease activity. There were no signs of active infection or other comorbid dermatological conditions. Given the severity of her condition and inadequate response to previous treatments, a decision was made to initiate soriatane therapy.

Sarah’s Psoriasis is Treated with Soriatane

I started Sarah on 25 mg of Soriatane once daily, with the option to change the dose based on response and tolerability. I scheduled regular follow-up appointments every four weeks to assess the treatment response and monitor for adverse effects. I also suggested emollient therapy to alleviate dryness and scaling associated with psoriasis plaques. Finally, I provided Sarah with information on proper skincare practices, lifestyle modifications, and potential side effects of Soriatane.

Sarah reported a noticeable improvement in her psoriasis symptoms at the first follow-up appointment after four weeks of Soriatane therapy. The itching had subsided, and the plaques appeared less inflamed and thinner. Her PASI score decreased to 9.2, indicating a significant reduction in disease severity. Sarah reported minimal side effects, primarily dryness of the lips and mild elevation of liver enzymes, which were monitored closely.

Over the subsequent months, Sarah continued to show steady improvement with Soriatane therapy. By the sixth month of treatment, her PASI score dropped to 3.6, signifying almost complete resolution of psoriasis symptoms. She expressed satisfaction with the treatment outcome and noted a substantial improvement in her quality of life.

Given the sustained efficacy and tolerability of Soriatane therapy, Sarah was transitioned to a maintenance dose of 25 mg every other day. She was advised to continue regular follow-up appointments for long-term monitoring and promptly report any new symptoms or concerns.

Things to Know About Soriatane

While Soriatane manages psoriasis symptoms, it carries a range of potential side effects that require careful monitoring by a licensed medical professional. Understanding these side effects and the importance of prompt follow-up with a healthcare provider is essential for ensuring the safe and effective use of Soriatane.

One of the most concerning side effects of Soriatane is its teratogenicity, meaning it can cause severe congenital disabilities if taken during pregnancy. Females of childbearing potential must use highly effective contraception before, during, and after treatment with Soriatane to prevent pregnancy. Additionally, strict pregnancy prevention programs are often implemented to ensure patient compliance and minimize the risk of fetal exposure to the medication.

Other common side effects of Soriatane include mucocutaneous dryness, such as dry lips, skin, and eyes, which can be managed with regular moisturization and lubricating eye drops. Increased susceptibility to sunburn and photosensitivity may also occur, necessitating sun protection measures, including sunscreen and protective clothing.

Furthermore, Soriatane can affect liver function, leading to elevated liver enzymes. Therefore, monitoring liver function tests is crucial to detect any abnormalities early and adjust treatment accordingly. In some cases, Soriatane may also elevate blood lipid levels, increasing the risk of hyperlipidemia and cardiovascular disease. Patients with pre-existing cardiovascular risk factors should be closely monitored and may require lipid-lowering therapy.

Psychiatric side effects, such as depression, mood changes, and suicidal ideation, have been reported with Soriatane use. Patients and their caregivers should be vigilant for any changes in mood or behavior and promptly report them to a healthcare provider for further evaluation.

Patients prescribed Soriatane should understand the potential side effects and the importance of regular follow-up with a licensed medical professional. Any signs or symptoms of adverse effects, including mood changes, gastrointestinal disturbances, or unexplained fatigue, should be promptly reported to ensure timely intervention and management. Through close monitoring and proactive communication with healthcare providers, patients can safely navigate Soriatane therapy while maximizing its therapeutic benefits in managing severe psoriasis.

Victory Over Psoriasis

Sarah’s case highlights the successful management of severe psoriasis with Soriatane therapy in a patient who had previously experienced limited treatment success. Through careful monitoring and patient education, Sarah showed significantly improved psoriasis symptoms and overall quality of life. Soriatane emerged as an effective therapeutic option, offering long-term remission and minimal adverse effects for this challenging dermatological condition.