Acrokeratosis Paraneoplastica Medication

Updated: Jan 23, 2017
  • Author: Katherine R Garrity, MD; Chief Editor: William D James, MD  more...
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Medication

Medication Summary

The goal of pharmacotherapy in acrokeratosis paraneoplastica is to improve scaly lesions, reduce morbidity, and prevent complications.

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Antipsoriatic Agent, Systemic

Acitretin (Soriatane)

Acitretin is a metabolite of etretinate and related to both retinoic acid and retinol (vitamin A). Its mechanism of action is unknown. However, it is thought to exert its therapeutic effect by modulating keratinocyte differentiation, keratinocyte hyperproliferation, and tissue infiltration by inflammatory cells.

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Antipsoriatic Agent, Topical

Salicylic acid topical

By dissolving the intercellular cement substance, salicylic acid produces desquamation of the horny layer of skin while not affecting structure of viable epidermis.

Hydrate the skin and enhance the effects of the medication by soaking the affected area in warm water for 5 minutes prior to use. Remove any loose tissue with a brush, wash cloth, or emery board and dry thoroughly. Improvement should generally occur in 1-2 weeks.

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Topical Skin Product

Calcipotriene (Dovonex)

Calcipotriene is a synthetic vitamin D-3 analog that regulates skin cell production and development. It inhibits epidermal proliferation, promotes keratinocyte differentiation, and has immunosuppressive effects on lymphoid cells. It is used in the treatment of moderate plaque psoriasis. Use 0.005% cream, ointment, or solution.

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Dietary Supplements

Cholecalciferol (Delta-D, Vitamin D-3)

Cholecalciferol stimulates the absorption of calcium and phosphate from the small intestine and promotes the release of calcium from bone into blood. It has antiproliferative and anti-inflammatory effects on skin.

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Corticosteroids

Betamethasone topical (Diprolene, Betatrex)

Betamethasone topical is for inflammatory dermatoses responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.

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Mineral, Parenteral

Zinc

Zinc is a cofactor for more than 70 types of enzymes. It plays a role in many metabolic processes. A higher requirement may be indicated in pregnancy.

Use the sulfate or gluconate zinc salts. Zinc sulfate 4.4 mg = 1 mg of elemental zinc. Zinc gluconate 7.1 mg = 1 mg of elemental zinc.

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