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Acitretin is the main active acid metabolite of etretinate. Both compounds are equally effective for the treatment of psoriasis, Darier's disease, and other disorders of keratinization, and both are equally teratogenic. Acitretin, however, has the advantage of more rapid elimination from the body and therefore causes less concern for women of childbearing potential. In countries where acitretin has been approved, the manufacturer has removed etretinate from the market. This report from the United Kingdom describes three patients with diseases that responded to etretinate but not to acitretin.
The patients were an 82-year-old man with punctate keratoderma, an 18-year-old woman with Darier's disease, and a 30-year-old man with extensive plaque…