A randomized comparative trial of two low-dose oral isotretinoin regimens in moderate to severe acne vulgaris

Dhaked, Daulat Ram; Meena, Ram Singh; Maheshwari, Anshul; Agarwal, Uma Shankar; Purohit, Shobha

doi:10.4103/2229-5178.190505

Cited by 21 publications

(18 citation statements)

References 27 publications

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“…A positive history of acne correlated with an improved treatment response in our study. Although the clinical efficacy of isotretinoin in HS is debated, isotretinoin is well established as a successful treatment for acne [11,21,29] . Isotretinoin has been described to improve symptoms in patients with the acne triad (HS, acne, and dissecting cellulitis of the scalp) [21,26] .…”

Section: Discussionmentioning

confidence: 99%

A New Perspective on Isotretinoin Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review of Patient Outcomes

Huang

Kirchhof

2017

Dermatology

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Background: Hidradenitis suppurativa (HS) is a disease characterized by the development of painful, deep-seeded nodules and abscesses. Treatment guidelines include a combination of lifestyle, surgical, and medical interventions. Isotretinoin has not been included in the treatment guidelines due to the limited number of studies and conflicting reports of efficacy. Objectives: The purpose of this study is to evaluate the clinical response to isotretinoin in HS patients and to determine whether there is a particular patient population that may benefit more from this treatment. Methods: A retrospective chart review was conducted on all HS patients treated with isotretinoin within the years of 2014-2016. Sex, age, weight, history of acne, Hurley stage, and treatment dose and duration were extracted from patient charts. Results: Of the 25 patients included in the study, 32% (8/25) had no response, 32% (8/26) showed partial response, and 36% (9/25) demonstrated complete response to isotretinoin treatment. Complete response was seen only in Hurley stage I and II patients. Hurley III patients made up 50% of the non-responders. Those with any sort of treatment response were more likely to be female, younger, weigh less, and have a higher prevalence of acne compared to non-responders. Limitations: This is a retrospective chart review with a small sample size of 25 patients. Conclusions: Physicians should consider isotretinoin as a potential treatment for HS, as it may be beneficial in patients with mild and moderate disease and patients who are female, younger, weigh less, and have a personal history of acne.

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Section: Discussionmentioning

confidence: 99%

A New Perspective on Isotretinoin Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review of Patient Outcomes

Huang

Kirchhof

2017

Dermatology

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“…The benefits of regimens with 0.3 to 0.4mg/kg/day, 20mg/day, 20mg every other day, 5mg/day, in the treatment of moderate acne, with the same efficacy, fewer side effects and greater adherence to treatment. 89-91 However, this is not recommended for use in leaflets. These regimens may be a useful option for AFA resistant to topical and hormonal treatments by reducing adverse events.…”

Section: Systemic Treatmentmentioning

confidence: 99%

Adult female acne: a guide to clinical practice

Bagatin

Freitas

Machado

et al. 2019

An. Bras. Dermatol.

112

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BackgroundAcne in women is often associated with anxiety and depression, and may persist from adolescence as well as manifest for the first time in adulthood. Genetic and hormonal factors contribute to its etiopathogenesis, and maintenance treatment is required, usually for years, due to its clinical evolution.ObjectiveTo develop a guide for the clinical practice of adult female acne.MethodsA team of five experts with extensive experience in acne conducted a literature review of the main scientific evidence and met to discuss the best practices and personal experiences to develop a guide containing recommendations for the clinical practice of adult female acne.ResultsThe group of specialists reached consensus on the main guidelines for clinical practice, providing detailed recommendations on clinical picture, etiopathogenesis, laboratory investigation and treatment of adult female acne.ConclusionDifferent from teenage acne, adult female acne presents some characteristics and multiple etiopathogenic factors that make its management more complex. This guide provides recommendations for best clinical practices and therapeutic decisions. However, the authors consider that additional studies are needed in order to provide more evidence for adult female acne to be better understood.

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“… 40 It was approved for severe acne (conglobata and nodular-cystic), but evidence demonstrated in controlled randomized clinical trials (CRCTs) since 1980, in systematic reviews (SRs), consensuses, and recommendations of dermatology societies allowed to expand the indication for nodular-cystic and moderate papulopustular forms resistant to other treatments, with tendency to scarring, and emotional and social functional impairment. 1 , 2 , 36 , 38 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 A single course of the drug leads to cure in two-thirds of patients. Recurrences may take place, but they are milder and manageable with topical treatments.…”

Section: Resultsmentioning

confidence: 99%

Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology

Bagatin

Costa

Rocha

et al. 2020

Anais Brasileiros de Dermatologia

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Background Isotretinoin is a synthetic retinoid, derived from vitamin A, with multiple mechanisms of action and highly effective in the treatment of acne, despite common adverse events, manageable and dose-dependent. Dose-independent teratogenicity is the most serious. Therefore, off-label prescriptions require strict criteria. Objective To communicate the experience and recommendation of Brazilian dermatologists on oral use of the drug in dermatology. Methods Eight experts from five universities were appointed by the Brazilian Society of Dermatology to develop a consensus on indications for this drug. Through the adapted DELPHI methodology, relevant elements were listed and an extensive analysis of the literature was carried out. The consensus was defined with the approval of at least 70% of the experts. Results With 100% approval from the authors, there was no doubt about the efficacy of oral isotretinoin in the treatment of acne, including as an adjunct in the correction of scars. Common and manageable common adverse events are mucocutaneous in nature. Others, such as growth retardation, abnormal healing, depression, and inflammatory bowel disease have been thoroughly investigated, and there is no evidence of a causal association; they are rare, individual, and should not contraindicate the use of the drug. Regarding unapproved indications, it may represent an option in cases of refractory rosacea, severe seborrheic dermatitis, stabilization of field cancerization with advanced photoaging and, although incipient, frontal fibrosing alopecia. For keratinization disorders, acitretin performs better. In the opinion of the authors, indications for purely esthetic purposes or oil control are not recommended, particularly for women of childbearing age. Conclusions Approved and non-approved indications, efficacy and adverse effects of oral isotretinoin in dermatology were presented and critically evaluated.

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A randomized comparative trial of two low-dose oral isotretinoin regimens in moderate to severe acne vulgaris

Cited by 21 publications

References 27 publications

A New Perspective on Isotretinoin Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review of Patient Outcomes

A New Perspective on Isotretinoin Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review of Patient Outcomes

Adult female acne: a guide to clinical practice

Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology

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