Acitretin (A) was compared to etretinate (E) in severe generalized psoriasis of plaque-like type in a randomized double-blind multicentric study over twelve weeks. The results showed that after 50 mg/d monotherapy both groups had a 60.4% and 60.0% improvement, respectively. PSI-score (x) decreased from 30.0 (A) and 28.5 (E) at baseline to 9 and 11.5 points, respectively. The clinical efficacy was comparable at all time points and at the end of the drug treatment phase. Thirty-two patients after A and 30 after E terminated the drug phase of the study with very good to excellent results and gave their consent to enter the double-blind randomized follow-up part of the study