Acne vulgaris in the elderly: the response to low-dose isotretinoin

Seukeran, D.C.; Cunliffe, W.J.

doi:10.1046/j.1365-2133.1998.02321.x

Cited by 39 publications

(43 citation statements)

References 5 publications

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“…There are some untoward effects, e.g., chelitis, facial erythema, dryness and peeling of the skin, hair loss, conjunctivitis, and hypercholesterolemia, and so on (15,18,19). These untoward reactions are reversible (18,(20)(21)(22) and most patients can tolerate treatment well (19,20). Therefore, oral cis-RA treatment appears to be a safe method, which may be helpful in preventing the recurrence of PVR after retinal reattachment surgery.…”

Section: Discussionmentioning

confidence: 87%

“…Doses as low as 0.1 mg/kg may work as well (16)(17)(18)(19)(20)(21)(22)(23). There are some untoward effects, e.g., chelitis, facial erythema, dryness and peeling of the skin, hair loss, conjunctivitis, and hypercholesterolemia, and so on (15,18,19). These untoward reactions are reversible (18,(20)(21)(22) and most patients can tolerate treatment well (19,20).…”

Section: Discussionmentioning

confidence: 93%

“…The usual course of treatment is 15-20 weeks. Doses as low as 0.1 mg/kg may work as well (16)(17)(18)(19)(20)(21)(22)(23). There are some untoward effects, e.g., chelitis, facial erythema, dryness and peeling of the skin, hair loss, conjunctivitis, and hypercholesterolemia, and so on (15,18,19).…”

Section: Discussionmentioning

confidence: 94%

“…However, cis-RA has the advantage that it had been used as an oral treatment for various skin diseases and tumors for a long time and in a large number of patients (15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

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Effects of Retinoic Acid on Retinal Pigment Epithelium from Excised Membranes from Proliferative Vitreoretinopathy

Mehta

et al. 2005

Journal of Ocular Pharmacology and Therapeutics

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It has been reported that retinoic acid (RA) may inhibit the growth of RPE and be used in the treatment of proliferative vitreoretinopathy (PVR). However, previous reports in this field have been conflicting. The main reason for these contradictory findings is that different methods for evaluating the effects of RA on RPE from different species have been used. In human specimens, only RPE from the donor eye (stationary) but not RPE from the PVR membrane (already at active proliferation status) have been tested. This study tested the effects of RA on the growth of RPE using a novel in vitro model: RPE from the PVR membranes, which simulates the in vivo situation of PVR patients better than RPE from the donor eyes. This study also used various methods to solve the conflicting results reported previously. We found that both all transretinoic acid (all-RA) and 13-cis-retinoic acid (cis-RA) can promptly (though not completely) inhibit proliferation of RPE (inhibition rate of 89%-90%) over a very wide range of concentrations (10(-9)-10(-5) M) and various lengths of periods (2-12 days) in a dose-dependent and time-dependent manner and without evident cytotoxic effects. Previously reported disadvantages discovered from the study of RPE from donor eyes, e.g., the absence of inhibitory effects on the early passages of cultured cells and inhibition occurring only after long-term treatment, do not present in RPE cells from the PVR membrane. The proliferation of RPE recovered from the inhibition by RA rapidly after the discontinuation of treatment, indicating that a continuous supply of the drug over a long period, i.e., until the breakdown of the blood-retinal barrier has been repaired, is essential for the success of drug treatment of PVR.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Effects of Retinoic Acid on Retinal Pigment Epithelium from Excised Membranes from Proliferative Vitreoretinopathy

Mehta

et al. 2005

Journal of Ocular Pharmacology and Therapeutics

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“…In an endeavor to surmount this limitation and to make the regimen cost-effective, lowdose regimens for mild/moderate grades of acne have been advocated. [7,8] Isotretinoin is the only drug that affects almost all factors in acne pathogenesis and is now established as a successful therapeutic option with the ability to induce long-term remission in patients with acne vulgaris. Isotretinoin was earlier prescribed for the cases of nodulocystic acne but is now increasingly used to treat patients of moderate-to-severe acne vulgaris, which are not responsive to topical therapy or oral antibiotics.…”

Section: Resultsmentioning

confidence: 99%

A randomized, open-label, comparative study of efficacy of low-dose continuous versus low-dose intermittent oral isotretinoin therapy in moderate-to-severe acne vulgaris

Shetti¹,

Hn²,

Hanumantharaya³

2017

Natl J Physiol Pharm Pharmacol

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Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for patients with moderate-to-severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low-dose treatment protocols. Aims and Objectives: The aim of this study was to assess and compare the efficacy of oral isotretinoin in low-dose continuous and intermittent treatment of moderate-to-severe acne vulgaris. Materials and Methods: This was a prospective, randomized, open-labeled, comparative, efficacy study carried out at Outpatient Clinic in the Department of Dermatology in Mandya Institute of Medical Sciences, Mandya. Out of 120 patients screened, 100 patients were selected. Patients with moderate-to-severe acne were assigned equally (50 patients each) to one of the two treatment regimens using block randomization technique, Group A was given lowdose continuous regimen -20 mg of oral isotretinoin once daily for 4 months and Group B was given low-dose intermittent regimen -20 mg of oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4 th week during the treatment period. A 6-month follow-up evaluation after the end of treatment was performed. The outcome of the therapy was based on the improvement in the global acne grading system (GAGS) score and patients' satisfaction with the treatment in the 4-point scale. Results: This study showed statistically significant clinical improvement and difference in GAGS score between Group A and Group B (P < 0.005). Conclusion: This study suggests that, considering clinical efficacy, low-dose continuous treatment is most suitable for patients with moderate-to-severe acne vulgaris.

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Treatment of acne with intermittent and conventional isotretinoin: a randomized, controlled multicenter study

Akman

Durusoy

Senturk³

et al. 2007

Arch Dermatol Res

111

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Oral isotretinoin is the most eVective choice in the treatment of severe acne. Application of isotretionin to acne has been expanded to treat those patients with less severe but scarring acne who are responding unsatisfactorily to conventional therapies. However, its use is associated with many side eVects, some of which can result in very disastrous consequences. Data related with intermittent isotretinoin therapy is still limited. Our aim was to asses the eYcacy and tolerability of two diVerent intermittent isotretinoin courses and compare them with conventional isotretinoin treatment. In this multicenter and controlled study, 66 patients with moderate to severe cases were randomized to receive either isotretionin for the Wrst 10 days of each month for 6 months (group 1), or each day in the Wrst month, afterwards the Wrst 10 days of each month for 5 months (group 2) or daily for 6 months (group 3). The drug dosage was 0.5 mg/kg/day in all groups. Patients were followed-up for 12 months. EYcacy values were evaluable for 22 patients in group 1, 19 patients in group 2, and 19 patients in group 3. Acne scores in each group were signiWcantly lower at the end of treatment and follow-up periods (P < 0.001). When patients were evaluated separately as moderate (n = 31) and severe (n = 29), no statistically signiWcant diVerences were obtained among the treatment protocols in patients with moderate acne. However, there was a signiWcant diVerence between groups 1 and 3 to the response of the treatments in severe acne patients at the end of follow-up period (P = 0.013). The frequency and severity of isotretionin-related side eVects were found to be lower in groups 1 and 2 compared with group 3. Intermittent isotretinoin may represent an eVective alternative treatment, especially in moderate acne with a low incidence and severity of side eVects. The intermittent isotretinoin can be recommended in those patients not tolerating the classical dosage.

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Acne vulgaris in the elderly: the response to low-dose isotretinoin

Cited by 39 publications

References 5 publications

Effects of Retinoic Acid on Retinal Pigment Epithelium from Excised Membranes from Proliferative Vitreoretinopathy

Effects of Retinoic Acid on Retinal Pigment Epithelium from Excised Membranes from Proliferative Vitreoretinopathy

A randomized, open-label, comparative study of efficacy of low-dose continuous versus low-dose intermittent oral isotretinoin therapy in moderate-to-severe acne vulgaris

Treatment of acne with intermittent and conventional isotretinoin: a randomized, controlled multicenter study

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