Background: Bexarotene, a novel and unique synthetic P, RXR-selective retinoid, is available as retinoid a treatment for cutaneous T-cell lymphoma. In psoriasis, a common retanoid-sensitive disease, no data are available on bexarotene treatment.Objective: In this phase II study we investigated the safety, tolerability,and effectiveness of bexarotene in psoriasis at closes of 0.5 to 3.0 mg/kg/day.Methods: Fifty patients with moderate to severe plaque-type psoriasis were treated with bexarotene in 4 sequential dose-defined panels of 12-13 patients at closes of 1.0, 2.0, 0.5, and 3.0 mg/kg/day for 12-24 weeks. Patients were monitored for safety and clinical efficacy.Results: No serious adverse events related to the drug occurred. Bexarotene was well tolerated in most patients. Most frequently observed adverse events related to bexarotene were hypertriglyceridaemia (56%) and a decrease in free T4 serum levels (54%). Significant improvement of psoriasis after bexarotene at all closes was confirmed by)v a modified psoriasis area and severity index (mPASI), plaque elevation (PEL), and physicians global assessment (PGA). Overall response rates (greater than or equal to50% improvement) for mPASI, PEL, and PGA were 22%: 52%, and 36%, respectively. No significant close-response effect was established for these parameters.Conclusion: The present study indicates an anti-psoriatic effect of bexarotene. Further studies are necessary to assess the optimal close and the potential for hexarotene as a new therapy for psoriasis.

Xeroderma pigmentosum (XP) is a rare autosomal recessive disease which affects the DNA repair system. Xeroderma pigmentosum is categorized in 7 complementation groups (A to G), with a defect in the nucleotide excision repair and 1 variant type, with a defect in the post-replication repair. Therefore, patients with XP are unable to normally repair UV-induced DNA damage in keratinocytes which results in increased pigmentation and early development of actinic keratosis, nonmelanoma skin cancer and melanoma. The prevalence of skin cancer is 1000-fold increased, with very early onset.

This article describes the consensus on the treatment of acne, reached by a Belgian working group. An effective treatment has to rely as much as possible on the pathophysiologic factors: the increased production of sebum, the abnormal desquamation (retention hyperkeratosis) of the epithelium of he sebaceous gland, the proliferation of Propionibacterium acnes and inflammation. The therapeutic arsenal contains topical as well as systemic drugs. This consensus gives an overview of both modalities and an algorithm is presented describing the practical approach to acne treatment.