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effects of oral isotretinoin

Sarah Qureshi, Jennifer Y Lin
Aminolevulinic acid (ALA) photodynamic therapy (PDT) is an emerging modality in the treatment of acne. While ablative fractional lasers have been used to enhance drug delivery into the epidermis, recent evidence suggests that non-ablative fractional photothermolysis may also improve uptake of ALA. We explored the use of non-ablative 1550 nm laser as a safe alternative in the delivery of ALA prior to red-light PDT for refractory inflammatory and cystic acne. Subjects referred for treatment of acne refractory to several topical and oral regimens, including isotretinoin, were pre-treated with non-ablative fractional photothermolysis (NAFP)...
October 14, 2016: Lasers in Medical Science
Daulat Ram Dhaked, Ram Singh Meena, Anshul Maheshwari, Uma Shankar Agarwal, Saroj Purohit
BACKGROUND: Oral isotretinoin is highly effective in all forms and grades of acne, even in lower dosages (<0.5 mg/kg/day). There is a paucity of comparative data on the various low-dose regimens of oral isotretinoin in the Indian literature. OBJECTIVES: To assess and compare the efficacy and tolerability of two low-dose oral isotretinoin treatment regimens (20 mg daily and 20 mg alternate days) in moderate to severe acne vulgaris. MATERIALS AND METHODS: A total of 240 patients with moderate to severe acne vulgaris were selected and randomized into two groups and treated with a fixed dose of 20 mg of isotretinoin (Group A - daily and Group B - alternate days) for 24 weeks and followed up for 12 weeks post therapy...
September 2016: Indian Dermatology Online Journal
Sergio Santos-Alarcon, Celia Sanchis-Sanchez, Almudena Mateu-Puchades
BACKGROUND: Darier's disease (DD) is an autosomal dominant skin disorder which causative gene, ATP2A2, is located atchromosome 12q23-24. The lesions of DD are skin-coloured to brown, hyperkeratotic, greasy papules that coalesce into warty plaques commonly involving the seborrhoeic areas of the trunk and face, especially the scalp margins, temples, ears, and scalp. The most common complaint associated with the disease is itching, with exacerbations attributed to heat, sweating, sunlight, lithium, steroid therapy, stress, and menstruation OBJECTIVES: We report a patient with DD treated with topical diclofenac sodium 3%...
2016: Dermatology Online Journal
Bengu Cevirgen Cemil, Havva Hilal Ayvaz, Gulfer Ozturk, Can Ergin, Havva Kaya Akıs, Muzeyyen Gonul, Ercan Arzuhal
INTRODUCTION: Isotretinoin has been successfully used for the treatment of acne vulgaris. AIM: To investigate the effects of isotretinoin on body mass index (BMI), to determine whether isotretinoin causes any changes in serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients, and to correlate variables. MATERIAL AND METHODS: Thirty-two patients were included in this study. Oral isotretinoin was begun at a dose of 0.5-0.6 mg/kg and raised to 0...
August 2016: Postȩpy Dermatologii i Alergologii
Duriye Deniz Demirseren, Fadime Kilinc, Selma Emre, Mesut Akyol, Ahmet Metin, Akin Aktas
BACKGROUND: The purpose of our study is to find out in which weeks and in which cumulative doses the side effects emerge and to study whether or not there is a significant variance between the observed period and doses of the emergent side effects of the patients taking the daily doses of below and above 0.5 mg/kg. METHODS: Patients were started treatment with doses of 0.25-1 mg/kg isotretinoin, and a form was given to the patients to mark which probable side effects occurred in which weeks and called for weekly follow-up for the first 2 months...
September 15, 2016: Journal of Dermatological Treatment
Lilia R S Guadanhim, Rubens G Gonçalves, Ediléia Bagatin
BACKGROUND: Acne vulgaris is a chronic inflammatory disease characterized by non-inflammatory and inflammatory lesions that can cause scarring. Oral isotretinoin is the current recommended treatment for moderate and severe cases; however, there are reports of possible influences on the healing process of the skin, leading to an increase in the risk for hypertrophic scars and keloids. This hypothesis, although unproven, represents a contraindication to the treatment of acne scars during the 6-12 months after the cessation of isotretinoin...
November 2016: International Journal of Dermatology
Omprakash Heggadahalli Mahadevappa, Venkataram Mysore, Vishalakshi Viswanath, Salim Thurakkal, Imran Majid, Suresh Talwar, Sanjeev J Aurangabadkar, Manas Chatterjee, M Ramesh Bhat, Shyamanta Barua, Anil Ganjoo
BACKGROUND: The current standard recommendation is to avoid surgical interventions in patients taking oral isotretinoin. However, this recommendation has been questioned in several recent publications. AIM: To document the safety of cosmetic and surgical interventions, among patients receiving or recently received oral isotretinoin. MATERIALS AND METHODS: Association of Cutaneous Surgeons, India, in May 2012, initiated this study, at 11 centers in different parts of India...
April 2016: Journal of Cutaneous and Aesthetic Surgery
Guler Bugdayci, Mualla Polat, Hamdi Oguzman, Havva Yasemin Cinpolat
OBJECTIVES: The aim of this study was to model the use of reference change values (RCVs) for the follow-up of 4 parameters of patients using oral isotretinoin which is gaining widespread popularity for monitoring the side effects of the treatment. METHOD: 102 patients received 30 mg/day oral isotretinoin for 24 weeks for the diagnosis of acne vulgaris. RESULTS: Repetitive measurements of the patients were interpreted with RCVs, after comparing the first and second doses based on RCVs: TC, TG, AST and ALT results increased in 12%, 20%, 14% and 12% of the patients respectively...
August 2016: Laboratory Medicine
Kory Schrom, Terri Nagy, Eliot Mostow
Isotretinoin is used to treat severe and recalcitrant acne. Possible side effects include depression, suicide, and suicidal ideation; however, other studies suggest isotretinoin may improve mood and quality of life. Although iPLEDGE consenting warns about the risk of depression and suicidal ideation, there is no recommendation for screening tools. The patient health questionnaire-2 and the patient health questionnaire-9 are validated instruments that enable dermatologists to efficiently screen for depression before and after isotretinoin is initiated...
July 2016: Journal of the American Academy of Dermatology
Bartosz Miziołek, Beata Bergler-Czop, Anna Stańkowska, Ligia Brzezińska-Wcisło
Oral isotretinoin (13-cis-retinoinc acid) is a derivative of vitamin A and belongs to the first generation of retinoids, which act as synthetic isomers of retinoic acid (RA). It is a very effective agent in a treatment of acne vulgaris; however, multiple side effects related to therapy with retinoids preclude the use of isotretinoin in less severe acne vulgaris. A significant limitation for the administration of isotretinoin appears in case of concomitant kidney disease with a special attention regarding the safety of the agent in patients with lupus nephritis (LN)...
May 10, 2016: Cutaneous and Ocular Toxicology
Berna Solak, Teoman Erdem, Yalcin Solak
A few previous case reports related vitamin A and retinoid use with elevated serum uric acid (SUA) levels. Recently, a population based study showed an independent positive correlation of serum retinol with SUA levels. Despite increasing importance of SUA in a number of disease states, no study has examined the association between retinoids and SUA. We aimed to evaluate the effect of pharmacologic dose isotretinoin on SUA level. This was a cohort study in which 51 consecutive adult patients with severe acne vulgaris who were prescribed oral isotretinoin treatment (0...
May 6, 2016: Journal of Dermatological Treatment
Elmas Korkmaz, Nilufer Cetinkaya, Murat Oz, Emre Ozgu, Sevda Bas, Mehmet Isikalan, Umran Buyukkagnici, Muzaffer Caydere, Sema Hucumenoglu, Tayfun Gungor
BACKGROUND: The study aims to determine the detrimental effects of 7.5 mg/kg/day isotretinoin treatment on the anti-Mullerian hormone (AMH) levels in an experimental study to see whether the effects on ovarian reserve are reversible. METHODS: Blood was sampled in 16 Sprague-Dawley albinos before any treatment to see baseline AMH levels. Then, the rats were randomly divided into 2 groups. Control group received only 1.0 ml soybean oil per oral for 30 days, whereas the study group received 7...
April 13, 2016: Gynecologic and Obstetric Investigation
Sendhil Kumaran Muthu, Tarun Narang, Uma N Saikia, Amrinder Jit Kanwar, Davinder Parsad, Sunil Dogra
BACKGROUND: Lichen planus pigmentosus (LPP) is a cosmetically distressing pigmentary disorder often posing a therapeutic challenge. Isotretinoin has been shown to be effective in oral and cutaneous LP, but its role in LPP is yet unknown. OBJECTIVE: To evaluate the efficacy and safety of isotretinoin in the management of LPP. METHODS: In this prospective study, 32 clinically and histologically proven patients with LPP were recruited. Subjects were treated with fixed low-dose (20 mg/day) oral isotretinoin once daily for 6 months along with topical sunscreens...
September 2016: International Journal of Dermatology
Lucio Vilar, José Luciano Albuquerque, Ruy Lyra, Erik Trovão Diniz, Frederico Rangel Filho, Patrícia Gadelha, Ana Carolina Thé, George Robson Ibiapina, Barbara Sales Gomes, Vera Santos, Maíra Melo da Fonseca, Karoline Frasão Viana, Isis Gabriella Lopes, Douglas Araújo, Luciana Naves
Objective. This prospective open trial aimed to evaluate the efficacy and safety of isotretinoin (13-cis-retinoic acid) in patients with Cushing's disease (CD). Methods. Sixteen patients with CD and persistent or recurrent hypercortisolism after transsphenoidal surgery were given isotretinoin orally for 6-12 months. The drug was started on 20 mg daily and the dosage was increased up to 80 mg daily if needed and tolerated. Clinical, biochemical, and hormonal parameters were evaluated at baseline and monthly for 6-12 months...
2016: International Journal of Endocrinology
Jerry Tan, Sanwarjit Boyal, Karishma Desai, Sanja Knezevic
Oral isotretinoin is unrivalled in efficacy and remission capability for treatment of acne. In addition to appropriate monitoring and continued vigilance for safety concerns, appropriate dosing to mitigate avoidable dose-dependent adverse effects is the responsibility of prescribers. Low-dose regimens are better tolerated and effective in inducing acne clearance. Although much progress has been made since the advent of isotretinoin, there remain many unanswered questions regarding optimization to maximize response while minimizing the potential for avoidable adverse events...
April 2016: Dermatologic Clinics
Jisha M Lucca, Niphy Annie Varghese, Madhan Ramesh, Dushad Ram
Isotretinoin, an oral vitamin A derivative, used to treat severe treatment-resistant acne. Psychiatric side effects of isotretinoin particularly depression and suicidal thoughts have been well documented. We report a case of isotretinoin-induced manic psychosis in a young female without a family history and history of mental illness.
January 2016: Indian Journal of Dermatology
James Leyden
The central role of inflammation in acne is now more clearly understood. Adapalene, a third-generation topical retinoid, down-regulates toll-like receptor 2 expression and inhibits activator protein-1 activity. In a fixed-dose combination, adapalene and benzoyl peroxide (BPO) act synergistically on inflammatory patterns through regulation of innate immunity. In addition to reducing inflammatory and non-inflammatory lesions, adapalene/BPO helps prevent lesion and microcomedone formation. The combination of a topical retinoid and antimicrobial agent remains the preferred approach for almost all patients with acne...
2016: Journal of Dermatological Treatment
Mualla Polat, Şahap Kükner
CONTEXT: Acne vulgaris is a puberty-onset chronic inflammatory disease of the pilosebaceous unit. Isotretinoin is a derivative of vitamin A commonly used for severe and nodulocystic acne. While isotretinoin has many side effects related to the eye, visual system and lacrimation, there is no information regarding isotretinoin's influence on contrast sensitivity. AIM: To investigate the effect of isotretinoin on visual contrast sensitivity and the amount of lacrimation...
February 24, 2016: Cutaneous and Ocular Toxicology
Emilie Sbidian, Éric Vicaut, Henri Chidiack, Elie Anselin, Bernard Cribier, Brigitte Dréno, Olivier Chosidow
Rosacea is a chronic inflammatory facial skin disease with psychosocial impact. Oral cyclines are recommended for moderate-to-severe papulopustular rosacea. Oral isotretinoin was found valuable for difficult-to-treat cases in several reports. This multicenter, double-blind, randomized-placebo-controlled trial compared oral isotretinoin (0.25 mg/kg/day) with placebo (2:1 ratio) for difficult-to-treat papulopustular rosacea. Included patients had at least eight papulopustular lesions. The primary endpoint after the 4-month treatment period was the response rate: at least 90% reduction of the number of papules/pustules compared with baseline...
June 2016: Journal of Investigative Dermatology
Luís Fernando Ungarelli, Cristina Marly Cunha Hetem, Jayme Adriano Farina Junior
BACKGROUND: Oral isotretinoin is increasingly being used to treat acne and other dermatological conditions. The number of patients who take isotretinoin and wish or need to undergo plastic surgery may be following a similar pattern. Although skin healing is an important concern in the case of patients who use isotretinoin, it is definitely not the only relevant issue when planning surgical intervention. METHODS: Eleven important points regarding surgery safety in patients taking oral isotretinoin were defined...
February 2016: Aesthetic Plastic Surgery
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