Acitretin-induced differentiation syndrome in a case of generalized pustular psoriasis

Arterial blood gas analysis showed respiratory alkalosis with metabolic acidosis, however, renal function test and serum electrolytes were normal. Differentiation syndrome is seen in 2–27% of acute promyelocytic leukemia patients on all trans retinoic acid, with 5% mortality. [1] Diagnosis is based on the presence of at least two of the following signs and symptoms: dyspnea, unexplained fever, weight gain >5 kg, unexplained hypotension, acute renal failure and chest radiograph demonstrating pulmonary infiltrates or pleuro-pericardial effusion.