Etretinate offers a new avenue for exploration and therapy of previously resistant dermatoses and tumors. Unfortunately, the drug most often suppresses and rarely cures any given condition. Because of its toxicity, a majority of patients are unable to continue on long-term therapy; many request an alternative form of medication after 3 to 6 months. Perhaps this is fortunate, as the adverse reactions seem to accumulate and increase in frequency with long-term administration. Even for patients, especially young women, with conditions apparently ideally suited for etretinate, it may be wise to exhaust all other available options, including a trial of isotretinoin, before beginning etretinate.