Systemic retinoids are used in the management of chronic cutaneous conditions and life-threatening dermatoses. Unfortunately, drug-induced hypertriglyceridemia may necessitate either dose reduction or discontinuation of therapy. The purpose of this article is to describe the successful management of isotretinoin-induced hypertriglyceridemia with gemfibrozil in a leukemia patient. Sequential serum chemistries were performed prior to, during, and following treatment with a systemic retinoid and a lipid-regulating agent. A prompt and sustained normalization of fasting triglycerides occurred following the initiation of gemfibrozil in a patient with isotretinoin-induced hypertriglyceridemia. When retinoids are being used in the management of serious conditions, the initiation of therapy with gemfibrozil to reduce the elevated triglycerides may be appropriate in those patients with retinoid-induced hypertriglyceridemia.
Testosterone replacement therapy is a treatment utilized for male hypogonadism. A subcutaneous testosterone pellet is a long-acting, slow-release delivery system that can be utilized as androgen replacement therapy. A 77-year-old man who was treated with testosterone pellets developed dermatitis consisting of erythematous plaques and patches on both buttocks and thighs within 28 days following the subcutaneous insertion of testosterone pellets. The skin lesions rapidly resolved with high-potency topical corticosteroid application. The same cutaneous eruption occurred with each subsequent insertion of testosterone pellets. Other cutaneous adverse events associated with testosterone pellet insertion include acne, hirsutism, and male pattern alopecia. Bleeding, bruising, fibrosis, infections, pellet extrusion, scarring, and subcutaneous nodules may also occur at the injection site. In summary, testosterone pellet-induced dermatitis is a rare adverse cutaneous event, which should be added to the list of potential testosterone pellet associated skin side effects.
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