Retinoid Side Effects — SCE Dermatology MCQ
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Correct answer: E — Continue effective contraception and pregnancy testing for three years after stopping
Explanation lettering: D = shown as A · A = shown as B · B = shown as C · E = shown as D · C = shown as E
C is correct. Acitretin is exceptionally important to distinguish from isotretinoin and alitretinoin: pregnancy prevention continues for three years after stopping, with pregnancy testing at 1–3-month intervals according to pregnancy risk. Alcohol can promote formation of the much longer-lived metabolite etretinate, but the three-year requirement applies irrespective of a reassuring current drug concentration. The one-month post-treatment interval applies to isotretinoin and alitretinoin, not acitretin. Three months and one year are not UK programme intervals, and undetectable acitretin does not cancel the regulatory precautions. This replaces an unsupported claim that acitretin causes benign yellow palms from retinoid metabolites.
Reference: MHRA oral-retinoid Pregnancy Prevention Programme requirements: https://www.gov.uk/drug-safety-update/oral-retinoid-medicines-revised-and-simplified-pregnancy-prevention-educational-materials-for-healthcare-professionals-and-women