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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
Farah Sameem, Semira
Oral isotretinoin has been in widespread use for more than three decades. It causes numerous side effects; skin and mucous membrane being commonly involved. Musculoskeletal adverse effects are also known to occur, but pelvic girdle myopathy is rarely reported. We report myopathy involving pelvic girdle muscles in a young male who received oral isotretinoin for folliculitis decalvans.
September 2016: Indian Journal of Pharmacology
Abdullah Alakeel, Marie Ferneiny, Nicole Auffret, Christine Bodemer
Acne fulminans (AF) is a rare manifestation and the most severe form of the entire clinical spectrum of acne. The disease is destructive and is characterized by the sudden onset of painful and ulcerative pustules and systemic symptoms including high fever, hepatomegaly, polyarthralgia, leukocytosis, plaquetose, and increased inflammatory markers and transaminases. Osteolytic lesions in multiple skeletal sites could also be associated. The use of isotretinoin is considered a related trigger, as well as the use and cessation of testosterone, although a bacterial infection, a drug-induced disease, or an intake of anabolic androgenic steroids has been suggested...
October 4, 2016: Pediatric Dermatology
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
Lucia Mantovani, Stefania Zauli, Annarosa Virgili, Vincenzo Bettoli
Rosacea fulminans, previously called pyoderma faciale, is an inflammatory disease considered a dramatic form of rosacea rather than of acne. Typical features are: exclusive facial involvement of young women, sudden onset of large nodules without other signs of acne, remission without scarring or with minimal scars, no recurrences or systemic symptoms. Oral isotretinoin associated with a short course of systemic and topical corticosteroids represent the recommended treatment. Personal observation of 5 cases has induced us to make a review of worldwide literature in order to better define this clinical entity...
October 2016: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
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
R J Conklin, J E Taunton
In brief: The treatment of acne is basically the same for athletes and nonathletes. However, certain aspects of sports can affect acne adversely, and in some cases treating athletes may require a cautious approach. The best treatments are topical tretinoin for comedonal acne, benzoyl peroxide or topical antibiotics and tretinoin for comedonal and mild pustular acne, and a combination of oral antibiotics and long-term benzoyl peroxide or topical antibiotics (with the eventual aim of stopping the oral antibiotics in three to five months) for moderate to severe pustular acne...
October 1988: Physician and Sportsmedicine
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
A Kumar, V K Kumar
BACKGROUND: Isotretinoin, an oral retinoid, has been utilized to achieve long term remissions in cases of recalcitrant acne. In the conventional dosage schedule, the use of oral isotretinoin has been limited by the occurrence of biochemical abnormalities such as hypertriglyceridaemia and impaired liver function tests and radiological changes consistent with diffuse idiopathic skeletal hyperostosis. Low-dose intermittent regimen of oral isotretinoin has been evolved as a cost effective alternative to the conventional dosage regimen in cases of acne...
July 2010: Medical Journal, Armed Forces India
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
Atishay Bukharia, Sweta Komal, V Madhu Sudhanan, Shyam Sundar Chaudhary
Olmsted syndrome is a very rare and severe cicatrizing keratoderma associated with periorificial lesion. Most cases are sporadic but familial occurrence has been also seen. Till now around 73 cases have been reported and none of the reported cases have 4 siblings affected from this disease. We are reporting cases of 4 siblings of age 30 year female, 26 year female, 20 year male and 10 year male who were born to a third degree consangueinous marriage and presented with palmoplantar keratoderma, periorificial hyperkeratosis, flexion deformity, pseudoainhum and contracture of digits...
May 2016: Indian Journal of Dermatology
Tiffany Czilli, Jerry Tan, Sanja Knezevic, Colin Peters
BACKGROUND: Acne affects a large proportion of the Canadian population and has psychosocial and financial consequences. OBJECTIVE: We provide cost information for treatments recommended by the Canadian acne guidelines. METHODS: Highest level recommendations were selected for 3-month usage cost. RESULTS: Three-month estimated treatment costs were as follows: topical retinoids ($14.40-$73.80), benzoyl peroxide (BPO; $6...
June 8, 2016: Journal of Cutaneous Medicine and Surgery
A Debroy Kidambi, N J Tiffin, H M Ramsay
Rosacea fulminans is a rare disorder of unknown cause, almost exclusively affecting women. There are only a few reported cases in men. The condition is characterized by the abrupt onset of pustules and nodules predominantly affecting the cheeks or chin without any systemic upset. We report the case of a 37-year-old man who presented with papulopustules, predominantly localized to his nose. Histopathological features were consistent with rosacea fulminans. The patient was managed with treatments including oral prednisolone, isotretinoin, and trimethioprim...
2016: Dermatology Online Journal
Cagatay Caglar, Engin Senel, Emine Sabancilar, Mustafa Durmus
To evaluate the changes in ocular surface and functions of tear-film in patients treated with systemic isotretinoin, to assess diagnostic performance of ocular surface disease index (OSDI) test in the dry eye conditions in association with the use of isotretinoin, and to determine the correlation between all tear-film function tests, OSDI and the dose and duration of isotretinoin administration. One hundred and twenty eyes of 60 subjects treated with oral isotretinoin were enrolled. All patients underwent ophthalmic examination at the baseline and another examination during the course of treatment...
May 18, 2016: International Ophthalmology
H P Gollnick, V Bettoli, J Lambert, E Araviiskaia, I Binic, C Dessinioti, I Galadari, R Ganceviciene, N Ilter, M Kaegi, L Kemeny, J L López-Estebaranz, A Massa, C Oprica, W Sinclair, J C Szepietowski, B Dréno
BACKGROUND: Many current guidelines provide detailed evidence-based recommendations for acne treatment. OBJECTIVE: To create consensus-based, simple, easy-to-use algorithms for clinical acne treatment in daily office-based practice and to provide checklists to assist in determining why a patient may not have responded to treatment and what action to take. METHODS: Existing treatment guidelines and consensus papers were reviewed. The information in them was extracted and simplified according to daily clinical practice needs using a consensus-based approach and based on the authors' clinical expertise...
September 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
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
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