Acitretin

Acitretin

Uses

Used to treat psoriasis. Acitretin is also used occasional to treat other skin diseases such as hand dermatitis, lichen planus, ichthyosis, warts, and solar keratoses.

Acitretin (Brand name Soriatane) is a retinoid used in the treatment of severe resistant psoriasis. It works by slowing down the proliferation of skin cells, and has been proven effective in about half of patients, with improvement starting to show two weeks after treatment, although it may take 2 to 3 months for the full benefit to take effect. In fact, psoriasis may actually get worst during the initial stages of treatment. Acitretin controls psoriasis but does not cure it.

Acitretin has also been used to treat Palmoplantar pustulosis, Hand dermatitis, Darier disease, Lichen planus
Lupus erythematosus, Cutaneous T-cell lymphoma, extensive granuloma annulare, severe ichthyosis, solar keratoses and skin cancers, and warts.

Dosing

Acitretin comes in a capsule and is taken by mouth once a day with a meal. Your doctor may start you on a lower dose and increase it over time.

Side Effects

Side effects may include dry lips, dry nose, dry eyes, dry or peeling skin, increased susceptibility to sunburn, headaches, muscle or joint aches, or shedding. In rare cases, it may also result in hepatitis or mood changes. It can also cause disturbances in the blood sugar level, including high blood sugar which, left untreated, can result in diabetic ketoacidosis. If you experience the following symptoms, you should notify your doctor immediately: nausea and vomiting, chest pain, blurred vision, dizziness, shortness of breath, breath that smells fruity, or decreased consciousness.

Notes of Precaution

Pregnant women, or women who expect to be pregnant in the next three years, should not take Acitretin. Acitretin may harm the fetus.

Do not breastfeed while taking Acitretin.

Avoid alcohol while on Acitretin for for two months after.

Notify your doctor if you are allergic to Acitretin or other types of retinoids.

Avoid prolonged exposure to sunlight while taking Acitretin.

Acitretin may impair your ability to see at night. Take this into consideration if you drive after dark.

Because Acitretin may cause eye dryness, wearing contact lenses may be uncomfortable.

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Uses

Used to treat psoriasis, psoriatic arthritis, rhuematoid arthritis, ankylosing spondylitis,  and Crohn's Disease.

Adalimumab (brand name: Humira) is a fully human recombinant antibody to tumor necrosis factor alpha (TNF) utilized in the treatment of autoimmune disorders, including psoriasis of the skin or joints.   It works by directly binding to TNF molecules in the blood and tissue, moderating inflammation that would have resulted from unbound TNF.Studies have indicated that up to 70 percent of patients who use adalimumab may experience 75 percent reduction of the skin plaques of psoriasis within four months, while 10 to 15 percent may clear completely. Although its success rate is high, like all other treatments for chronic disorders, adalimumab does not cure the condition but only controls or suppresses the disease, and must be used on a long-term basis.

Dosing

Adalimumab is administered by subcutaneous injection every two weeks. It is available as a pre-filled syringe or an "auto-injector" pen. Patients, after counseling, can usually self-inject at home into the thigh or abdomen, rotating injection sites to reduce potential soreness.

Side Effects

Adalimumab functions by suppressing an immune response, which unchecked, can damage a patient's own tissue resulting in clinical disease. Although this range of immune suppression is narrow and not likely to lead to problems, infection remains the most important cause for concern with this type of "biologic" medication, especially if combined with other immune suppressing medicines.   Your doctor will likely order a tuberculosis (TB) skin test prior to starting therapy with adalimumab and will be repeated yearly. There may be an increased risk of upper respiratory infections, and soreness may occur at the site of injection. You should discuss any planned immunizations with your doctor if taking adalimumab. Other reported side effects have included headache, sinusitis, rash and nausea. Rarely neurologic problems, lymphomas, leukemias and other cancers have been reported in patients taking TNF blockers like adalimumab. As with all new medications, advise your doctor of all your current medicines if prescribed adalimumab.

Notes of Precaution

Adalimumab should be kept refrigerated and warmed to room temperature 15 minutes before injection

Advise your doctor if you have ever been treated for tuberculosis, hepatitis, or cancer before beginning adalimumab

If you are pregnant or plan to be pregnant, you should discuss thoroughly with your physician the potential benefits and risks of therapy

Patients with congestive heart failure or multiple sclerosis should use caution while taking adalimumab.

* Consult with your doctor prior to taking any immunizations, especially live vaccines