Treatment: acitretin (and alitretinoin)

A few days before the first prescription (after at least 1 month of contraception)

• Serum β-hCG (woman of childbearing potential)if neededTest under medical supervision, sensitivity of at least 25 mIU/mL, at least 1 month after starting contraception and shortly before the first prescription; it must confirm the absence of pregnancy ^[2].
• AST
• ALT
• GGT
• Bilirubin
• Lipid profile (total cholesterol, triglycerides)
• Fasting plasma glucose
• Serum creatinine with eGFR

Every 15 days for the first 2 months

• AST
• ALT

At 1 month

• Lipid profile (total cholesterol, triglycerides)

Then every 3 months

• AST
• ALT
• Lipid profile (total cholesterol, triglycerides)

Every month, on the day of the visit or in the 3 days before

• Serum β-hCG (woman of childbearing potential)if neededTests to be done as far as possible every month during treatment, depending on sexual activity, periods and contraception; dates and results recorded ^[2].

Every 1 to 3 months for 3 years after stopping

• Serum β-hCG (woman of childbearing potential)if neededPeriodic pregnancy tests every 1 to 3 months for 3 years from the end of treatment: the risk of malformation persists until complete elimination ^[2].

Before, then during treatment (fasting for the lipid profile)

• Serum β-hCG (woman of childbearing potential)if neededBefore (at least 1 month after starting contraception, shortly before the first prescription), as far as possible every month during treatment, and 1 month after stopping ^[7].
• Fasting lipid profile (cholesterol, triglycerides)
• TSH (known hypothyroidism)if neededUncontrolled hypothyroidism contraindicates alitretinoin; the treatment often lowers TSH and free T4, reversibly ^[7].