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Low‐dose acitretin in P apillon– L efèvre syndrome: treatment and 1‐year follow‐up
Author(s) -
Sarma Nilendu,
Ghosh Chiranjit,
Kar Sudipta,
Bazmi Badruddin Ahmed
Publication year - 2014
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.12177
Subject(s) - acitretin , medicine , dermatology , psoriasis
The P apillon– L efèvre syndrome ( PLS ) is a rare, autosomal recessive disease that manifests with palmoplantar keratoderma and destructive periodontitis resulting in early onset periodontal breakdown in deciduous and permanent dentition. Management of this condition is difficult. Here we report one 11‐year‐old consanguineous M uslim boy suffering from PLS . After failing to get any benefit from methotrexate, three cycles of acitretin, each for 2 months, were given 1 month apart. In each cycle, acitretin (25 mg) was given every other day. A t the end of the third cycle, treatment was stopped for 4 months to observe the extent of relapse. Thereafter, acitretin (25 mg) was given twice weekly for 4 months and then the patient was followed up for 1 year. Treatment with acitretin resulted in excellent improvement of periodontitis, increase in the alveolar bone height, and periodontal attachment. Improvement remained stable at the end of 1‐year follow‐up. There was excellent (>75%) improvement in keratoderma at the end of active therapy. Mild worsening of palmoplantar keratoderma was noticed whenever the drug was stopped. It improved when the drug was restarted. Other areas remained stable. At the end of 1‐year follow‐up, good improvement (50%) in palmoplantar keratoderma was achieved.