Isotretinoin-Induced Thrombocytosis in a Patient With Acne Vulgaris: A Case Report

Abstract

Isotretinoin is one of the first-line medications for the treatment of acne. One of the reported side effects of isotretinoin is thrombocytopenia, in addition to other abnormalities such as incomplete blood count. However, reports on thrombocytosis associated with isotretinoin are controversial. The present report discusses the case of a patient with acne vulgaris who was treated with isotretinoin and consequently suffered from isotretinoin-induced thrombocytosis.A 20-year-old female patient was diagnosed with acne vulgaris and started treatment with systemic isotretinoin (20 mg once daily) for one month. A baseline complete blood count was performed, as well as another blood count after one month of medication administration. Platelet count was recorded at each visit. The baseline platelet count was within the normal range; however, it was found to be elevated after one month of treatment. Accordingly, the medication was discontinued, and the platelet count returned to normal levels after one month, as measured during the monthly visit. The patient also experienced seizure episodes during treatment, which did not cease with the treatment discontinuation. Although isotretinoininduced thrombocytosis is considered a rare side-effect for isotretinoin, it should be routinely monitored in high-risk patients and those undergoing surgeries. Further prospective studies on isotretinoin-induced thrombocytosis need to be conducted to gain a deeper insight into the various aspects related to the condition.

Evaluation of hematological parameters in patients using systemic isotretinoin with diagnosis of acne vulgaris

“…There are also case reports describing hematological side effects, such as isotretinoin-induced thrombocytosis, prolonged thrombocytopenia, agranulocytosis, and neutropenia, 7,8,9,14,15,16,17 and therefore, clinicians usually tend to evaluate hemogram parameters. In studies on hematological parameters, comparisons have been usually made between the values measured before treatment and at the third month of treatment, and different results have been reported.…”

Side Effects of Treating Acne Vulgaris With Isotretinoin: A Systematic Review

“…Topical creams or ointments can treat mild cases of acne vulgaris. However, systemic therapy will be necessary to treat the disease’s severe manifestations [ 4 ].…”

“…The only medication that can treat all of the pathogenic causes of acne is isotretinoin [ 6 ]. Despite the fact that isotretinoin is quite successful in treating acne vulgaris, the increasing frequency of adverse effects severely restricts its use [ 4 ]. The most notable effect is its teratogenicity [ 7 ].…”

“…In addition to these adverse effects, isotretinoin is known to produce a number of lab abnormalities, which include effects on the levels of plasma lipids and liver function tests [ 9 ]. Hematological profile disturbances are yet another significant side effect [ 4 ]. Therefore, it is advised to establish a baseline total blood count and to regularly check for any changes in blood count while treating acne vulgaris [ 4 ].…”

“…Hematological profile disturbances are yet another significant side effect [ 4 ]. Therefore, it is advised to establish a baseline total blood count and to regularly check for any changes in blood count while treating acne vulgaris [ 4 ].…”