Isotretinoin In Patients Research Articles

Correlation between depression scores and serum NF-ĸB/NLRP3 axis, biotinidase, and HMGB1 after treatment with isotretinoin in patients with acne vulgaris.

Acne vulgaris (AV) is an inflammatory skin disorder leading to scars and discomfort, its intensity has major psychological consequences such as depression. To investigate the effect of isotretinoin (ISO) on NF-κB/NLRP3, biotinidase, and HMGB and correlation with depression. This was a case-control study that involved two groups. Group 1 is 20 healthy control, and group 2 is 20 patients diagnosed with AV according to Global Acne Grading System (GAGS) and received 20 mg ISO for 2 months. Before and after therapy, the Hamilton Depression Rating Scale (HDRS) was applied to assess each participant's level of depression. Nuclear factor kappa B (NF-ĸB), biotinidase, high mobility group box protein (HMGB1), nucleotide-binding domain, leucine-rich-containing family, and pyrin domain-containing-3 (NLRP-3) were measured in serum samples. There was no significant difference in all measured markers of healthy group before and after 2 months. Regarding group 2, there was a statistically significant decrease in all measured markers after 2 months of treatment and significant correlations between GAGS, NF-ĸB, HMGB1, NLRP3, biotinidase, and depression score. Increased GAGS, HMGB1, NLRP3, and biotinidase were associated with depression severity in AV patients and ISO treatment significantly reduced these parameters and reduced depressive symptoms.

Evaluation of the effectiveness of a combination of incoherent broadband light (IPL) and low doses of systemic isotretinoin compared with monotherapy with standard doses of isotretinoin in patients with acne

BACKGROUND: Long-term experience of clinical use of isotretinoin for acne indicates that it has a good safety and efficacy profile; however, against the background of taking standard doses of isotretinoin, pronounced adverse events that are dose-dependent are noted. Therefore, the search for new combined treatment regimens that reduce the dose of isotretinoin is an urgent task.
 AIMS: The aim of our work was to evaluate the effectiveness of a combination of incoherent broadband light (IPL) and low doses of systemic isotretinoin (0.10.3 mg/kg of body weight per day) compared with monotherapy with standard doses of isotretinoin (0.51 mg/kg of body weight per day) in patients with acne.
 MATERIAL AND METHODS: During the study, the dermatological status of patients was assessed taking into account the dermatological index GSS (Global Severity Scog), dermatological acne index (DIA), IGA scale (Investigator's Global Assessment). For a comparative analysis of the impact of various techniques on the quality of life, a high-valid quality of life index (HQIQ) was used. Dermatological status and quality of life were assessed in patients before and after 6 months of therapy. 12 months after the end of therapy, patients were invited to the clinic to identify delayed relapses.
 RESULTS: Evaluating the overall results of treatment of patients with moderate severity of acne by isotretinone monotherapy and combination therapy with low doses of isotretinoin and broadband incoherent light, the effectiveness of both methods can be noted, however, according to the global severity scale (GSS), clinical remission was significantly more often observed in the combination therapy group compared with the motor therapy group (88 and 74%, respectively, p 0.05). In addition, no relapses were detected after 12 months in the combination therapy group, and adverse events caused by the use of isotretionine were also less frequent.
 CONCLUSION: Thus, the combination therapy of acne with low doses of isotretinoin and broadband incoherent light is more effective.

Investigation of systemic immune-inflammation index and systemic inflammation response index as an indicator of the anti-inflammatuary effect of isotretinoin in patients with acne vulgaris

Purpose Oral isotretinoin (ISO) can effect markers of inflammation in patients with acne vulgaris. Systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) were described as novel inflammatory and prognostic biomarkers. The present study aimed to evaluate the effectiveness of SII, SIRI, and other inflammatory markers in patients with acne vulgaris who receive isotretinoin therapy. Methods One hundred fifty-six patients with moderate-to-severe acne vulgaris who received at least 3 months of ISO treatment (0.5–1 mg/kg/day) and 100 healthy individuals were enrolled in the study. The medical records and laboratory findings of the participants were reviewed retrospectively. Pre-treatment and post-treatment neutrophil, lymphocyte, monocyte, and platelet counts, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), SII, SIRI, total cholesterol, LDL cholesterol, triglyceride, HDL cholesterol, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were analysed. Results Before ISO treatment, patients with moderate-to-severe acne vulgaris had significantly higher platelet counts than healthy controls (p = 0.003). Serum total cholesterol, LDL, triglyceride, AST, and ALT increased significantly after isotretinoin treatment in patients with acne vulgaris (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.029, respectively). In the follow-up of patients using ISO, a significant increase was found in platelet levels (p < 0.001). However, neutrophil, NLR, SII, and SIRI were found significantly decrease after ISO treatment (p = 0.047, p = 0.038, p = 0.003, p = 0.001; respectively). Lymphocyte, monocyte, PLR, and MLR did not show any significant change after ISO treatment. Conclusion SII and SIRI are better parameters as an indicator of the anti-inflammatory effect of isotretinoin than other inflammatory markers.

Ocular manifestations of systemic isotretinoin in patients with acne: a systemic review and meta-analysis

Purpose To examine the effects of systemic isotretinoin treatment on the eye using several ocular examination parameters. Methods We conducted a systemic review for literature published up to June 2021 in both PubMed and Web of Science databases. We included prospective observational or interventional studies evaluating ocular manifestations of isotretinoin in acne patients. The primary outcome measures were anaesthetized and non-anaesthetized Schirmer test, tear break-up time (TBUT), central corneal thickness (CCT), average retinal nerve fibre layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IP) thickness, subfoveal choroidal thickness, axial length, ocular surface disease index (OSDI), meibomian gland expression (MGE) and conjunctival stain. The National Institute of Health (NIH) quality assessment tools were used to assess the data quality. The effect size used to analyse the included studies was the weighted mean difference (WMD) and its related confidence intervals (95%CIs). Results Twenty-one publications involving 1105 eyes of 842 participants met the inclusion criteria. Isotretinoin use was significantly associated with reduction in the scores of anaesthetized Schirmer (WMD = –2.23, 95%CI: −3.28 to −1.18), non-anaesthetized Schirmer (WMD = –3.74, 95%CI: −4.23 to −3.25), TBUT (WMD = –3.47, 95%CI: −5.09 to −1.86), and CCT (WMD= −7.39, 95%CI: −13.91 to −0.88). Isotretinoin use was significantly associated with increase of OSDI (WMD = 18.29, 95%CI: 7.54–29.03), MGE (WMD = 1.02, 95%CI: 0.70–1.33) and conjunctival stain scores (WMD = 0.61, 95%CI: 0.47–0.76). No significant change was noted in RNFL thickness (WMD = −0.64, 95%CI: −1.80 to 0.51); GC-IP thickness (WMD = 0.42, 95%CI: −1.08 to 1.92); subfoveal choroidal thickness (WMD = –1.80, 95%CI: −6.69 to 3.09), and axial length (WMD = 0.08, 95%CI: −0.19 to 0.35). A significant heterogeneity was found between the study estimates in each of anaesthetized Schirmer, TBUT, MGE, OSDI, and conjunctival stain tests. Conclusion Isotretinoin use results in a statistically significant reduction of the central corneal thickness, TBUT, and Schirmer test scores. A statistically significant increase in MGE, OSDI and conjunctival stain scores was found. No statistically significant change of average RNFL, GC-IP thickness, subfoveal choroidal thickness, or axial length was observed. Further well-designed studies should evaluate the long-term effect of isotretinoin on the eye and reach a firmer conclusion.

Efficacy and tolerability of system isotretinoin and effect of this therapy on the quality of life of patients with severe and moderate acne

Background. The relationship between acne and depression is being actively studied by the medical community. Question is depression a restriction in prescribing or a side effect when using systemic isotretinoin remains controversial. Noteworthy is the presence in the scientific literature of data on the possible positive effect of adequately and timely prescribed acne therapy on the psychoemotional state of patients with this ailment.&#x0D; Aims. The aim of our study was to evaluate the effectiveness of therapy with systemic isotretinoin in patients with moderate and severe acne, to assess the effect of the therapy on the quality of life of patients, as well as the persistence of remission after the end of the course of therapy with systemic retinoid.&#x0D; Methods. We observed 32 patients with moderate and severe acne, the average age of patients was 24 years, the duration of the disease was on average 8 years. All patients underwent therapy with systemic isotretinoin (Sotret) at an average daily dose of 0.51.0 mg/kg until a cumulative dose of 120150 mg/kg was reached. The effectiveness and tolerability of the therapy was assessed, as well as the quality of life of patients was assessed using the dermatological index of the quality of life (DQL), the dermatological akne index (DIA), the HADS scale (anxiety and depression scale). The indicators were assessed before the start of therapy, during therapy, at the end of the course of treatment with systemic isotretinoin, and also 12 months after the end of therapy.&#x0D; Results. 100% of patients achieved clinical remission as a result of treatment with systemic isotretinoin.&#x0D; Before starting therapy with systemic isotretinoin, the indices were as follows: DQL 18 (1520), HADS 10 (716) and DIA 13 (615) scores. By the end of the therapy, the indices decreased to 1 (01), 2 (04) and 1 (01) points, respectively (p 0.001).&#x0D; 12 months (year) after the end of therapy with systemic isotretinoin, the indices remained at zero or one level in all patients: DQL 1 (01), HADS 0 (01) and CIA 1 (01) points (p 0.001).&#x0D; Conclusion. A causal relationship between the intake of systemic isotretinoin and the development of depression has not been established. Systemic isotretinoin therapy was effective in all patients (100%), was well tolerated and had a positive effect on the psychoemotional status of patients with acne. 12 months after the end of therapy with the drug Erase, stable remission of the disease was noted in all patients

Analysis of the effects of isotretinoin on the premature epiphyseal closure in pediatric populations: a literature review.

Oral isotretinoin, a systemic retinoid and a vitamin A derivative, has been widely utilized to treat acne in both adult and pediatric populations. Additionally, systemic retinoids have also been utilized to treat neuroblastoma in pediatric patients. Common side effects associated with oral isotretinoin include dry eyes, dry mouth, elevated liver enzymes, depression, and arthralgia. Less common side effects of isotretinoin include hearing loss, pseudotumor cerebri, anaphylaxis, and skeletal abnormalities including growth arrest. The U.S. Food and Drug Administration (FDA) has received reports of premature epiphyseal closure in patients treated with isotretinoin retinoids, which are commonly prescribed by primary care providers as a treatment for acne. It is important to raise awareness of the potential side effects of isotretinoin to enable informed treatment decisions before beginning an isotretinoin regimen. This chapter aims to elucidate that isotretinoin, given at various doses and durations, has been associated with growth plate abnormalities, which can lead to premature epiphyseal closure. Two databases were utilized for the literature review and were conducted at different time periods. Our literature review was conducted between December 2020 and June 2021, utilizing PubMed with the following search terms: "isotretinoin" and "isotretinoin and premature epiphyseal closure." In April 2021, we searched the FDA's "Drug Data and Adverse Event Report System" utilizing the terms "isotretinoin" and "epiphysis premature fusion." We included in our query reports of patients worldwide under 18years of age with premature epiphyseal closure or growth plate damage secondary to isotretinoin. Studies published in English between 1980 and 2020 were also included, as well as background sources relating to an isotretinoin profile with side effects and dosing. We narrowed our search to exclude patients with a history of growth plate disorders due to trauma, malignancy, or other pathological processes, as well as patients with growth arrest due to endocrine factors. Growth plate abnormalities associated with retinoid derivatives other than isotretinoin were also excluded. A total of 28 items were selected for our literature review including: one FDA drug label, one FDA website of adverse reactions, 19 supplemental articles, six case reports, and one case series of premature epiphyseal closure secondary to isotretinoin. The FDA received 41 reports worldwide of premature epiphyseal closure related to isotretinoin in patients under 18years of age. Additionally, premature epiphyseal closure and growth plate abnormalities occurred in nine patients with various durations and doses of isotretinoin ranging from the lowest dose of 0.5mg/kg/day for a few months to 3.5mg/kg/day for years. Isotretinoin-induced premature epiphyseal closure and growth plate deformities seem to be linked to higher doses of isotretinoin for the duration of months to years. There have been reported cases of premature epiphyseal closure in individuals receiving therapeutic doses of isotretinoin for acne treatment, which are much lower compared to the high doses utilized for neuroblastoma. Based on this study, isotretinoin appears to impact the growth plates of proximal tibia and distal femur. A cause-and-effect relationship between isotretinoin and premature epiphyseal closure cannot be concluded.

How safe and effective is prescribing oral isotretinoin to treat acne in patients on renal dialysis? A systematic review.

Patients on renal dialysis often develop severe acne. In spite of this, the literature remains scarce about the use of isotretinoin for the treatment of acne in this group of patients, and many clinicians remain apprehensive and hesitant to use it. To systematically review the literature surrounding the safety and efficacy of isotretinoin for the treatment of acne in patients on renal dialysis. Four electronic databases (MEDLINE, Embase, CINAHL, Emcare) were systematically searched in March 2021. The search strategy incorporated the terms 'isotretinoin', 'renal', 'kidney', 'dialysis' and 'acne', along with terms closely related to these. Studies were considered eligible if they reported the use of isotretinoin for treatment of acne in patients with renal impairment or on renal dialysis, and if they had relevant implications to this topic. The search resulted in a total of 63 results. Using the PRISMA approach, 11 articles were deemed relevant to this review: 1 randomized single-blinded placebo-controlled trial, 2 case series, 2 retrospective studies and 6 case reports. Hence the level of evidence was mostly low (Grading of Recommendations, Assessment, Development and Evaluations level 3). This review of the literature suggests that low-dose isotretinoin (10-20 mg) can safely and successfully be used to treat severe acne in patients on renal dialysis, leading to a significant improvement in their quality of life. As the current literature on this topic is scarce, more studies would be beneficial to further establish the safe use of isotretinoin in patients on renal dialysis.

Results of Laboratory Monitoring in Patients Taking Isotretinoin for Acne.

Isotretinoin is one of the most effective drugs for the treatment of all forms of acne vulgaris. It has been suspected of causing alterations in lipids and liver enzymes. The aim of this retrospective study was to determine the prevalence of laboratory changes among 371 patients with acne receiving isotretinoin therapy. Each patient's medical records were evaluated to determine baseline alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, and triglycerides (TGs) compared to levels recorded at 2 later readings following initiation of treatment with oral isotretinoin. Results indicated that isotretinoin can be administered with minimal concern regarding changes in serum transaminase and lipid profiles. Nevertheless, physicians should be cautious when administering isotretinoin in patients with a history of abnormal findings.

The correlation of age, gender and drug dose with side effects of isotretinoin in patients with acne vulgaris

The correlation of age, gender and drug dose with side effects of isotretinoin in patients with acne vulgaris

Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline.

To compare the impact of ocular changes between systemic treatment with doxycycline and low-dose oral isotretinoin in patients with moderate-to-severe papulopustular rosacea. Patients were randomized to receive either isotretinoin 0.3-0.4 mg/kg (group A) or doxycycline 100 mg/day (group B) for 16 weeks. Ocular symptoms were searched and evaluated, including best-corrected visual acuity (BCVA), Schirmer test, breakup time, rose bengal staining score, and meibomian gland dysfunction grading. The patients were retested at the end of treatment. The present study included 39 patients (30 females and 9 males). Best-corrected visual acuity was > 20/30 in >90% of patients in both groups and did not change after treatment. After treatment, improvement in ocular symptoms and meibomian gland dysfunction was more pronounced in group B (p<0.05); the other parameters did not reach statistical significance. Doxycycline improved meibomian gland dysfunction, ocular symptoms, and ocular surface in patients with rosacea. Even though some patients experienced worsening meibomian gland dysfunction and symptoms, no subject experienced any serious complications after administration of low-dose isotretinoin.

Minimize the regular laboratory monitoring during the systemic isotretinoin treatment: data of 704 patients with acne vulgaris

Backround: Despite extensive usage of systemic isotretinoin in patients with acne for many years, laboratory monitoring protocols for adverse effects depend on the centers and there is no standardized practice for frequency and type of laboratory testing. We aimed to decrease unnecessary monitoring and to standardize our general clinical practice of our department as well as to provide patient comfort and cost saving.Materials and methods: The medical charts of 704 acne patients treated with systemic isotretinoin were reviewed retrospectively. The National Cancer Institute common terminology criteria for adverse events v3.0 grading system was used in order to categorize the laboratory abnormalities of liver functions and lipid levels.Results: All laboratory abnormalities were grade I. Abnormal liver function was seen in 7.2% of the patients (n = 51), maximum values were ALT: 87 IU/L, AST: 97 IU/L (normal values, ALT: 5–41 IU/L, AST: 5–40 IU/L) and median time of the abnormalities in liver function tests was in the second month. Lipid profile abnormalities were detected in 58% of the patients (n = 401). Maximum values during the laboratory monitoring were Tg: 481 mg/dL CHOL: 314 mg/dL, LDL: 259 mg/dL (normal values, Tg: 0–200 mg/dL, CHOL.: 0–200 mg/dL, LDL: 0–100 mg/dL). The median time of lipid abnormalities was in the first month (1–3 months). Abnormalities related to CBC were seen in 8.2% of the patients (n = 58). The median time of CBC abnormality was the second month of treatment. Anemia, leukopenia and thrombocytopenia were seen in 3.4%, 3.7%, and 1.6% of the patients respectively.Conclusion: Clinically insignificant and reversible CBC abnormalities, mild to moderate elevation of liver transaminases and serum lipids are the most common laboratory abnormalities in patients with acne treated with oral isotretinoin. Due to these abnormalities are reversible even the isotretinoin therapy continued, and generally there is no need to discontinuation of treatment due to laboratory abnormalities, frequent biochemical monitoring is not recommended.

The safety of isotretinoin treatment in patients with bone fractures

Isotretinoin is widely applicable in dermatology, although it may develop severe side effects in the skeletal system. An intention of this review was to establish the safety of oral isotretinoin in patients with bone fractures. Both MEDLINE/Pubmed and SCOPUS databases were searched to investigate the influence of isotretinoin on the skeletal system. The drug shows a strong osteoporotic activity in rats whereas this effect is milder in humans. Biochemical markers of bone turnover remain unchanged except for serum calcium in patients receiving a high dose of isotretinoin. An excessive intake of vitamin A may impair functioning of vitamin D especially in people with a vitamin D deficiency, therefore a similar side effect may also occur in patients on isotretinoin treatment. We suggest reducing the use of isotretinoin after bone injury or continuing the treatment at low dosing with a concomitant correction of vitamin D and calcium status.

Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis

ObjectiveThis study aimed to investigate the association between the use of isotretinoin and the risk of depression in patients with acne.DesignThis was a meta-analysis in which the standardised mean difference...

Comparative Effect of Topical Tacrolimus and Topical Isotretinoin in Patients with Oral Lichen Planus

Oral lichen planus (OLP) is a chronic autoimmune, mucocutaneous disease that has been treated for decades with different topical and systemic medicament that have been reported to be effective and includes topical and systemic corticosteroids, retinoid, ultraviolet phototherapy (PUVA), immunosuppressant and immune. But a resistant to treatment and a high risk of toxicities limit their use. This work was aimed to compare the effect of topical tacrolimus 0.1% gel and topical Isotretinoin 0.1% gel in patients with oral lichen planus. The samples groups are Twenty-eight Patients (16 females and 12 male, mean age 33.6 ±11.3 years; 14 patients per treatment group) with symptomatic erosive and atrophic OLP randomized in double-blind study to be treated with tacrolimus gel 0.1% (group A) or isotretinoin 0.1% gel (group b). The Results show High significant effectiveness of tacrolimus compared to isotretinoin in reducing oral pain and significant difference in reducing the signs of OLP. It can be concluded that the use of topical tacrolimus 0.1% gel is more effective than Isotretinoin 0.1% gel in the reducing of the pain and sings of oral lichen planus.

Is Oral Omega-3 Effective in Reducing Mucocutaneous Side Effects of Isotretinoin in Patients with Acne Vulgaris?

Background. Acne vulgaris is an inflammatory disease of pilosebaceous units which may cause permanent dyspigmentation and/or scars if not treated. Isotretinoin is recommended in the treatment of recalcitrant or severe acne, but it is associated with common adverse effects that frequently result in patients incompliance and discontinuation of the drug. The present study was designed to assess the efficacy of oral omega-3 in decreasing the adverse effects of isotretinoin. Materials and Methods. In this randomized double-blind clinical trial, a total of 118 patients with moderate or severe acne were randomly divided into two (case and control) groups. The control group was treated with isotretinoin 0.5 mg/kg, and the case group was treated with the same dose of isotretinoin combined with oral omega-3 (1 g/day). The treatment was lasted for 16 weeks and mucocutaneous side effects of isotretinoin were recorded and compared between the two groups in weeks 4, 8, 12, and 16. Results. Cheilitis (at weeks 4, 8, and 12), xerosis, dryness of nose at all weeks, and dryness of eyes (at week 4) were less frequent in the group that received isotretinoin combined with oral omega-3 compared to the group that received isotretinoin alone. Conclusion. Administration of oral omega-3 in acne patients who are receiving isotretinoin decreases the mucocutaneous side effects of isotretinoin. This trial is registered with IRCT201306238241N2.

Compliance with national guidelines on isotretinoin: where are we 2 years since the last audit? Results of the National Isotretinoin Re-Audit 2014.

In 2010, the British Association of Dermatologists (BAD) published clinical guidelines for the safe introduction and continued use of isotretinoin in patients with acne in the UK. The BAD provides UK dermatologists with a facility for national audit, and it undertook an audit on compliance with these guidelines in 2012. To determine current clinical practices relating to use of isotretinoin among dermatologists in the UK (including geographical variations) as measured against BAD standards, and to ascertain any improvement since the 2012 audit. The 2012 isotretinoin audit proforma was used, with additional questions on clinical setting, complaints and litigation. A web-based survey tool was used for data entry and submission, with email invitation to working, UK-based BAD members (n = 1226) in December 2013 and weekly reminders during the 8.5-week data collection period. Responders were requested to enter data for the three most recent consecutive patients (including one male and one female patient) who had completed treatment within the previous 6 months. In total, 338 (27.6%) respondents provided data on 1013 patients. Serum lipids were checked in 93.4% of patients and documentation of mental health and/or mood state was recorded in 82.1%. Regarding the Pregnancy Prevention Programme (PPP), 91.6% of female patients of childbearing potential had signed the PPP information form, while 93.3% who had followed the PPP had taken pregnancy tests both before and during treatment, and 54.7% had taken a pregnancy test 5 weeks post-treatment. Overall, there is currently good compliance with standards. Certain aspects of care that are less frequently preformed, such as pregnancy testing post-treatment, are highlighted.

A feasibility and phase II study of the hu14.18-IL2 immunocytokine in combination with GM-CSF and isotretinoin in patients with recurrent or refractory neuroblastoma: A Children’s Oncology Group study.

10017 Background: Combining anti-GD2 (disialoganglioside) monoclonal antibody with GM-CSF, IL2 and isotretinoin is now standard of care for high-risk neuroblastoma (NB) minimal residual disease (MR...

Assessment of the Efficacy and Safety of a Combination of 2 Topical Retinoids (RetinSphere) in Maintaining Post-Treatment Response of Acne to Oral Isotretinoin

IntroductionThe high rate of relapse of acne lesions following oral isotretinoin treatment is a common problem which remains unsolved. To avoid or minimize relapses, topical retinoids have been used for many years as maintenance treatment. However, adverse effects frequently occur. AimsTo determine the efficacy and safety of a new retinoid combination (Retinsphere technology) in maintaining post-treatment response to oral isotretinoin. Patients and methodsProspective, randomized, double-blind and vehicle-controlled study of 30 patients with acne previously treated with isotretinoin. Treatment with the retinoid combination was applied to one side of the face and vehicle was applied to the other, once daily, for 3 months. Standardized photographs were taken using RBX technology at baseline, 1.5 months and 3 months. The primary efficacy endpoint was the appearance of relapse on the treated side compared to the vehicle-treated side. Other endpoints included lesion count, investigator-reported improvement, patient-reported improvement, impact on quality-of-life, and side effects. ResultsAlthough the majority of patients did not reach the total target dose of oral isotretinoin, the relapse rate was significantly lower on the retinoid-treated side compared to the vehicle-treated side. Likewise, improved lesion count and excellent tolerance were observed. ConclusionsThis new retinoid combination (Retinsphere technology) were effective and safe as maintenance therapy after post-treatment response to oral isotretinoin in patients with acne.

English

BACKGROUND: Acne vulgaris is an almost universal problem of adolescence characterized by inflammation in and around sebaceous gland. Effective treatment is essential to prevent physical and psychological scarring. Antibiotic requires frequent administration and associated with side effects contributing to reduced compliance . Isotretinoin was a major therapeutic advanced which revolutionized the treatment of acne. Thus it is important to analyze its risk- benefit ratio at lower dosages. Hence the present study carried out with the objective of oral Isotretinoin in patients of moderate to severe grade acne vulgaris. METHODOLOGY: The present prospective study carried out among the acne vulgaris cases attending the out-patient department of dermatology at a tertiary care Centre during January 2007 to December 2007. Oral is otretinoin was started at a dose of 0.5 mg/kg/day for a total duration of 20 weeks. Patients were scheduled for 3 visits i.e. at the end of 1st, 2nd & 5th month after start of treatment. All collected data entered and analyzed using SPSS for efficacy of drug on different lesions. RESULTS: 38 (95%) patients completed the study and same were evaluated for efficacy and safety. 50% decrease in comedons at the end of 2 month from the initiation of treatment. The efficacy of oral isotretinoin on inflammatory lesions shows decreased from baseline 36.13 to 4.87 at the time of last visit at 5 month. This was statistically significant (0.0001). Side effects observed an 11% case includes dryness, palmoplantar peeling, exfoliative dermatitis, photosensitivity, facial dermatitis. CONCLUSION: The oral is otretino in is effective and safe as well as showing early response especially for inflammatory lesions.

Assessment of the Efficacy and Safety of a Combination of 2 Topical Retinoids (RetinSphere) in Maintaining Post-Treatment Response of Acne to Oral Isotretinoin

IntroductionThe high rate of relapse of acne lesions following oral isotretinoin treatment is a common problem which remains unsolved. To avoid or minimize relapses, topical retinoids have been used for many years as maintenance treatment. However, adverse effects frequently occur. AimsTo determine the efficacy and safety of a new retinoid combination (Retinsphere technology) in maintaining post-treatment response to oral isotretinoin. Patients and methodsProspective, randomized, double-blind and vehicle-controlled study of 30 patients with acne previously treated with isotretinoin. Treatment with the retinoid combination was applied to one side of the face and vehicle was applied to the other, once daily, for 3 months. Standardized photographs were taken using RBX technology at baseline, 1.5 months and 3 months. The primary efficacy endpoint was the appearance of relapse on the treated side compared to the vehicle-treated side. Other endpoints included lesion count, investigator-reported improvement, patient-reported improvement, impact on quality-of-life, and side effects. ResultsAlthough the majority of patients did not reach the total target dose of oral isotretinoin, the relapse rate was significantly lower on the retinoid-treated side compared to the vehicle-treated side. Likewise, improved lesion count and excellent tolerance were observed. ConclusionsThis new retinoid combination (Retinsphere technology) were effective and safe as maintenance therapy after post-treatment response to oral isotretinoin in patients with acne.