Combination therapy with acitretin and glycyrrhizin in generalized pustular psoriasis with liver test abnormalities: A case series.

Ning Yu, Ying Li, Yangfeng Ding, Yuling Shi

Dermatologic therapy 2020 May

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Liver test abnormalities (LTA) are a frequent extracutaneous manifestation in generalized pustular psoriasis (GPP). Due to possible hepatotoxicity of systemic monotherapy, it is challenging to simultaneously achieve clinical remission and LTA normalization. However, evidence for therapy is lacking. The aim of this study was to assess the effectiveness of combination therapy of acitretin and glycyrrhizin in nine GPP patients with LTA. During the acute phase of GPP, a combination of acitretin (0.5 mg/kg/d PO) and glycyrrhizin (80 mg/d intravenous) was initiated. After 2 weeks, all the patients promptly achieved at least 77% improvement in the severity score of GPP, as well as a significant reduction of liver enzymes. The patients were continuously treated with tapered doses of acitretin (20-30 mg/d PO) and glycyrrhizin (150 mg/d PO), and presented stable conditions during the 12-month follow-up. In conclusion, we consider that the combination of acitretin plus glycyrrhizin is an effective and safe therapy in GPP patients with LTA. © 2020 Wiley Periodicals LLC.

Citation

Ning Yu, Ying Li, Yangfeng Ding, Yuling Shi. Combination therapy with acitretin and glycyrrhizin in generalized pustular psoriasis with liver test abnormalities: A case series. Dermatologic therapy. 2020 May;33(3):e13318