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Acitretin and etretinate are synthetic retinoids used primarily for treating severe psoriasis. Etretinate is the ethylester form of acitretin, while acitretin is the active metabolite of etretinate with a shorter half-life. Both drugs work by normalizing keratinocyte differentiation and reducing inflammation. Etretinate was withdrawn from the market due to its long half-life and teratogenic effects, while acitretin replaced it as the preferred treatment. Both drugs are highly teratogenic, requiring strict contraception measures. Acitretin can be converted back to etretinate when combined with alcohol.
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