{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T21:07:18Z","timestamp":1784408838110,"version":"3.55.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 50-year-old man with a background of idiopathic CD4+ lymphocytopenia (ICL) was successfully treated with acitretin monotherapy for recalcitrant viral warts on the hands and right cheek. Treatment duration was 35 months, with sustained effects at 15 months post-acitretin therapy. Side-effects were mild and included mild cheilitis and dryness of nasal mucosa. CD4+ lymphocytes play an important role in enabling host responses to human papillomavirus (HPV) and, consequently, lower CD4 counts correspond to a higher risk of chronic HPV infection, including viral warts. HPV represents the most common opportunistic infection in patients with ICL. Acitretin is an oral retinoid with affinity for retinoic acid and retinoid X receptors, and works through downregulation of signal transducer and activator of transcription (STAT)1- and STAT3-dependent signalling, with resultant increases in keratinocyte differentiation. As HPV evades the Janus kinase\/STAT pathway to promote keratinocyte proliferation, acitretin may work through reversal of this mechanism. This case demonstrates effectiveness of acitretin in treating recalcitrant viral warts, specifically in a patient with ICL.<\/jats:p>","DOI":"10.1093\/skinhd\/vzaf025","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T14:49:44Z","timestamp":1748962184000},"page":"236-239","source":"Crossref","is-referenced-by-count":1,"title":["Successful management of recalcitrant cutaneous warts with low-dose acitretin monotherapy in a patient with idiopathic CD4+ lymphocytopenia"],"prefix":"10.1093","volume":"5","author":[{"given":"Moe","family":"Latt","sequence":"first","affiliation":[{"name":"Department of Dermatology, Harrogate and District Hospital NHS Foundation Trust , Harrogate ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4957-8503","authenticated-orcid":false,"given":"Alex","family":"Langrish","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medicine, York and Scarborough Teaching Hospitals NHS Foundation Trust , York ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M","family":"Layton","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Harrogate and District Hospital NHS Foundation Trust , Harrogate ,","place":["UK"]},{"name":"Skin Research Centre, University of York , York ,","place":["UK"]},{"name":"York Biomedical Research Institute, Hull York Medical School, University of York , York ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles J N","family":"Lacey","sequence":"additional","affiliation":[{"name":"York Biomedical Research Institute, Hull York Medical School, University of York , York 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