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Neotigason/Soriatane/Acitretin side effects

I live in the U.K. I am 28. and I've  had severe psoriasis for over 15 yrs. I have been taking Neotigason/Soriatane/Acitretin for 7 months, and had very good response, my psoriasis completely cleared.
However I was on a dosage of 60mg/day, and just before Christmas I was suddenly hit by the side effects below, which became intolerable. I found I could only tolerate the side effects by taking 25mg/day, however the psoriasis is creeping back, so I'm trying to increase the dosage slowly.

-- Worst --
1)   Skin is cold/clammy -can't get warm, becoming intolerable.
2)   Cheilitis -Dry/Badly peeling lips.
3)   Dry/Badly peeling palms of hands, soles of feet, skin around eyes.

-- Moderate --
4)   Abnormal Skin odor.
5)   Sticky skin all over body.
6)   Thin and splitting finger & toe nails.
7)   Paresthesia -Feeling of waves pin pricks running along my body.

-- Minor--
8)   Sore/dry eyes
9)   Sore/dry nostrils.
10)  Hair on head turned curly.
11)  Alopecia -Hair loss all over body (Including scalp initially).
12)  Hair colour turned much lighter (initially).

I was hopping that you could suggest anything to help reduce the cold skin feeling, and if possible any of the others, apart from the obvious of moisturizers etc.

My dermatologist doesn't acknowledge these as side effects, and I'd feel uncomfortable correcting him.
This is the web site of Roche who manufactures the drug, here you can see a list of side effects.
http://www.rocheusa.com/products/soriatane/pi.html#ADVERSE EVENTS

Many Thanks,

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242489 tn?1210500813

Unfortunately, I have almsot no clinical experience with this drug and am quite unfamiliar with it. In any case, most side-effects of the kind you list are dose-related.  This means that you can take only the does which produces side-effects which are tolerable.  Why you can suddenly tolerate less than half what you used to take I cannot explain.

Sorry I cannot be of more help.


Dr. R
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