Ulcerated atrophic striae from etretinate

Oral retinoids such as etretinate and acitretin are commonly associated wit h dose-dependent, mucocutaneous side effects such as dryness, peeling, and fragility. Although these effects can be extreme in some patients and even require discontinuation of treatment, thinning of skin to the point of atro phy and ulceration has never been reported in the English literature. We pr esent the case of a patient with psoriasis in whom ulcerated atrophic stria e developed during etretinate therapy. After discontinuation of etretinate, ail cutaneous ulcers resolved. Subsequently, the patient had a favorable r esponse to oral calcitriol (1,25-dihydroxy vitamin D3), a novel therapy for psoriasis.