Isotretinoin for acne vulgaris – an update on adverse effects and laboratory monitoring

Fallah, Haady; Rademaker, Marius

doi:10.1080/09546634.2021.1967269

Cited by 9 publications

(11 citation statements)

References 104 publications

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“… 8 The upregulation of SREBP-1 and 5-LOX may lead to AF because of their participation in sebum production. 38 …”

Section: Resultsmentioning

confidence: 99%

“…Chapped lips were also the adverse reaction. 38 , 43 However, evening primrose oil as a dietary supplement was considered safe, which could result in a significant increase in skin hydration in patients treated with ISO, and significantly ameliorate the adverse effects such as dryness, lip cracking, and peeling skin. 42 Retinoid dermatitis, burning sensation, and itching sensation were all adverse reactions caused by ISO, among the side effects of mucocutaneous, cheilitis was the most common adverse effect and dose-dependent.…”

Section: Resultsmentioning

confidence: 99%

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Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Ding¹,

Zheng²,

Jin³

2023

CCID

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Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.

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“… 8 The upregulation of SREBP-1 and 5-LOX may lead to AF because of their participation in sebum production. 38 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Ding¹,

Zheng²,

Jin³

2023

CCID

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“…Beside of incommon osteal changes (e.g nasal osteophytes and skletal hyperostosis), many others have been described in recent decades which are summerized in Table 2 . Combining an antihistamine to isotretinoin regimen may decrease adverse effects and improve its efficacy 11 , 16 , 17 .…”

Section: Discussionmentioning

confidence: 99%

Oral Isotretinoin Treatment in Rhinoplasty: A Review

Afzalzadeh,

Alizadeh

2023

WJPS

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The achievement of best outcome in rhinoplasty is very important for both of the patients and plastic surgeons. Since the skin characteristics (e.g. nasal thickness and sebaceous hypertrophy) has clear role on the result, many related interventions have been proposed in recent decades to gain an appropriate result. Accordingly, isotretinoin firstly introduced to treat some type of acne, has been suggested controversially to be used in rhinoplasty. Although the early uncertain studies implied on its side effects, the recent more powerful studies and evidences indicate that isotretinoin is remarkably effective to obtain proper outcome. Nevertheless, its prescription to patients need to be evaluated and personalized. More discussion on this regard are presented in the text.

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“…To the best of our knowledge, this is the first described case of renal thromboembolism and severe DCM leading to implantable cardioverter-defibrillator (ICD) implantation occurring during isotretinoin treatment. adverse effects of isotretinoin are cheilitis, teratogenicity, myalgia, and arthritis; conversely, cardiac toxicity is not acknowledged as common [3][4][5][6]. During hospital stay, isotretinoin was stopped, and recommended heart failure therapy was set up.…”

mentioning

confidence: 99%

“…Liver dysfunction is not infrequently observed in patients treated with RA and can affect the function of cystathionine-b-synthase, an enzyme involved in homocysteine metabolism, causing hyperhomocysteinemia [1,2]. Other common adverse effects of isotretinoin are cheilitis, teratogenicity, myalgia, and arthritis; conversely, cardiac toxicity is not acknowledged as common [3][4][5][6]. During hospital stay, isotretinoin was stopped, and recommended heart failure therapy was set up.…”

mentioning

confidence: 99%

A Young Patient Presenting with Dilated Cardiomyopathy and Renal Infarction during Treatment with Isotretinoin: Mere Coincidence or Serious Side Effect of a Drug Commonly Used in Adolescence?

et al. 2023

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Isotretinoin or 13-cis-retinoic acid (RA) is one of the most effective and widely used drugs for the treatment of severe acne vulgaris. Despite being deemed safe, no definite consensus has been reached on the cardiovascular risk of RA derivatives. We report a case of heart failure due to dilated cardiomyopathy (DCM) and concomitant renal infarction occurring after 5 months of isotretinoin use in a previously healthy 18-year-old male. The patient, with a history of acne vulgaris, presented to our emergency department with left iliac fossa pain and effort dyspnea. A trans-thoracic echocardiogram showed DCM and severely reduced left ventricle ejection fraction (LVEF: 29%). During hospitalization, a total body computed tomography (CT) showed an ischemic lesion in the left kidney. Ischemic, autoimmune, infective, and heritable causes of DCM were ruled out. Cardiac magnetic resonance (CMR) evidenced LV circumferential mid-wall late gadolinium enhancement. Heart failure therapy was promptly started and up-titrated, but only poor LVEF improvement was detected overtime. Our case aims to raise awareness on rare life-threatening cardiovascular events possibly associated with isotretinoin use. To the best of our knowledge, this is the first described case of renal thromboembolism and severe DCM leading to implantable cardioverter-defibrillator (ICD) implantation occurring during isotretinoin treatment.

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Isotretinoin for acne vulgaris – an update on adverse effects and laboratory monitoring

Cited by 9 publications

References 104 publications

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Oral Isotretinoin Treatment in Rhinoplasty: A Review

A Young Patient Presenting with Dilated Cardiomyopathy and Renal Infarction during Treatment with Isotretinoin: Mere Coincidence or Serious Side Effect of a Drug Commonly Used in Adolescence?

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