Acitretin Teratogenicity — SCE Dermatology MCQ
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Correct answer: C — At least 3 years before conception (due to Etretinate metabolite persistence)
Acitretin requires a minimum 3-year washout before conception — the longest of any dermatological medication. This is because Acitretin is converted to Etretinate (especially in the presence of alcohol), which has a half-life of approximately 120 days and accumulates in adipose tissue, maintaining teratogenic potential for years. This effectively makes Acitretin unsuitable for women of childbearing potential unless they are committed to reliable long-term contraception. In contrast, Methotrexate requires 3-month washout, and most biologics have shorter recommended washout periods. Isotretinoin (different retinoid, no Etretinate conversion) requires only 1 month post-treatment before conception.
Reference: BAD 2018 Pregnancy Guidelines; BNF