Salivary Gland Inflammation During Acitretin Therapy for Generalized Pustular Psoriasis: a Case Report and Diagnostic Challenge

Introduction
Generalized pustular psoriasis is a rare variant of pustular psoriasis characterized by erythematous skin lesions with sterile pustules. It is often triggered by medications, infections, or surgical procedures. Treatment options include treatment with systemic retinoids such as acitretin, ciclosporin, methotrexate, biologic agents (e.g., adalimumab, etanercept), with topical management, or phototherapy. Spesolimab, an interleukin-36 receptor antagonist, is currently the only biologic agent approved by both the Food and Drug Administration and European Medicines Agency for the treatment of generalized pustular psoriasis.

Case report
A case of salivary gland inflammation occurring during acitretin therapy given for generalized pustular psoriasis is presented. The reaction may represent a previously unreported adverse drug effect.

Conclusions
Salivary gland inflammation should be considered as an adverse effect of acitretin therapy. Further studies are warranted to elucidate this possible association.