Virginia C. Weiss

Chronic active hepatitis associated with etretinate therapy.

Acute hepatitis developed in a patient taking etretinate for severe psoriasis. Discontinuation of therapy was followed by progression of the histological changes to chronic active hepatitis, despite improvement of his clinical and laboratory status. This is the third reported case of chronic active hepatitis associated with etretinate therapy, and the second patient in our group of twenty‐two etretinate‐treated patients with severe psoriasis to develop clinically significant hepatic disease. Immunological evaluation revealed a marked increase in the patients OKMI‐staining population of peripheral mononuclear cells and augmentation of Con A‐induced lymphocyte blastogenesis in the presence of etretinate.

Altered erythrocyte membrane phosphorylation in psoriasis

Autophosphorylation by [y‐32P]ATP of erythrocyte membranes from controls, psoriatic patients and patients with skin disorders other than psoriasis was compared by polyacrylamide gel electrophoresis. Compared with controls, membranes from psoriatic patients showed significantly less 32P incorporation in the band 2 region (nomenclature of Fairbanks et al., 1971). In addition, psoriasis and some of the other skin diseases examined displayed decreased phosphorylation in the region of bands 2.9‐3 and 4.5‐4.8. A new polypeptidc band in the 18‐20,000 dalton region was also observed in the diseases examined. Altered epidermal plasma membranes have been implicated in the pathogenesis of psoriasis, and our findings suggest the defective plasma membranes may be a generalized phenomenon in this disorder.

Erythrocyte membrane phosphorylation in untreated and in etretinate-treated psoriatic patients*

Levels of phosphorylation were decreased in bands 2 to 2.1, 2.9 to 3 and 4‐5 to 4‐8 of erythrocyte membranes from psoriatic patients compared with control values. In addition, higher than control levels of 32P were incorporated into a new polypeptide hand (mol. wt. 18‐20,000 daltons) of red cell membranes from patients. Uptake of 32P by these bands returned towards normal after the patients received oral etretmate treatment. These results suggest there is a gcneralixed plasma membrane defect in psoriasis and that ctretinate may affect the metabolism of red cell membrane proteins.