BLEPHAROCONJUNCTIVITIS AND ACITRETIN

We report external ocular side effects after treatment with acitretin, a new synthetic vitamin A analogue and the main metabolite of etretin ate. A patient treated with 20-25 mg/day of acitretin for psoriasis su ffered from chronic blepharoconjunctivitis. Schirmer tests, tear lysoz yme were normal while rose bengal and fluorescein staining disclosed e pithelial punctate defects and tear break-up time was shortened. Meibo mian glands of the lower lid were photographed with transillumination and appeared atrophic. Conjunctival cytology and biopsy showed snake-l ike chromatine appearance, keratinized epithelial cells and some lymph ocytes infiltrates. Accessory salivary gland histological aspects were nonspecific. There was a clear relationship between restarting the ac itretin therapy and recurrence of ocular symptoms. Acitretin, like oth er retinoids, may induce or exacerbate blepharoconjunctivitis in patie nts with psoriasis.