Fixed Tapering Dosage of Acitretin in Patients with Psoriasis: A Short-Term Analysis of Clinical Efficacy and its Effects on Biochemical Parameters

Background:

Acitretin is a widely used systemic retinoid in the treatment of psoriasis. Dosage of acitretin in not weight adjusted due to certain interindividual variations.

Objective:

To evaluate the clinical efficacy and effects on biochemical parameters of fixed tapering dosage of acitretin in patients with psoriasis administered over a period of 4 weeks.

Materials and Methods:

This was an observational study. The study included patients of psoriasis vulgaris in the age group of 18 and 65 years with a psoriasis area severity index (PASI) score of >10 which was not responsive to topical therapy and phototherapy. Patients were given oral acitretin daily at a dose of 25 mg BD for 2 weeks, which was later tapered to 25 mg OD for another 2 weeks. The clinical efficacy and biochemical parameters were assessed.

Results:

Out of the 18 patients, PASI 75 was achieved in 66% of the patients by the end of the third week. Significant elevations were noted in serum lipids during 4 weeks, which returned to normal limits or near baseline levels at the end of 4 weeks.

Conclusion:

Fixed tapering dose of acitretin is effective in psoriasis with minimal clinical and biochemical adverse events

Pyeloplasty in infants and children with particular reference to the method of drainage post-operatively

Sixty-three consecutive Anderson-Hynes pyeloplasties in infants and children have been reviewed with particular reference to any influence the method of drainage might have on the post-operative course and the final radiological result. Extra-anastomotic drainage usually with a sump drain, was used in 40 cases and pyelostomy drainage in 23 cases. Fewer post-operative complications were encountered in the former group. The final radiological result was not influenced by the method of drainage except that, in patients under 2 years of age, those with pyelostomy drainage fared rather better. It is concluded that (a) extra-anastomotic sump drainage is the method of choice following pyeloplasty in children over 2 years of age, and (b) in infants under 2 years of age pyelostomy drainage probably should be combined with a trans-anastomotic splint.