Vnitr Lek 2024, 70(2):120-125 | DOI: 10.36290/vnl.2024.024

Suspicion of a hypervitaminosis A during acitretin therapy

Markéta Kobzová, Pavel Polák
Interní oddělení, Vojenská nemocnice Brno

The authors present a clinical case of a 90 years old woman treated with acitretin for psoriasis during past two years, in whom develloped spontaneously haemorrhagic blisters on extremities, on oral mucosal surfaces and large subcutaneous hematomas. In the differential diagnostic work-up an allergy to co-trimoxazole, plazmocellular neoplasia, amyloidosis and bacterial endocarditis were suspected. Both microscopic evaluation as microbial cultivation of the aspirated hemorrhagic fluid were concluded as contamination. There were no signs of paraproteinemia in serum immunoelektrophoresis study. Extended medical history revealed till months persisting xerophthlamia, xerostomia, nail fragility and hair loss, which all are consistent with hypervitaminosis A. The bleeding signs subsided within several days after acitretin withdrawal. Both the drug serum concentrations and retinol concentrations were not performed.

Keywords: acitretin, hypervitaminosis A, bleeding.

Accepted: March 26, 2024; Published: April 10, 2024  Show citation

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Kobzová M, Polák P. Suspicion of a hypervitaminosis A during acitretin therapy. Vnitr Lek. 2024;70(2):120-125. doi: 10.36290/vnl.2024.024.
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