The efficacy of oral isotretinoin versus cyproterone compound in female patients with acne and the triad of cutaneous hyperandrogenism: A randomized clinical trial

Abstract

Background:SAHA (Seborrhea, Acne, Hirsutism and Androgenetic Alopecia) syndrome is a dermatologic disorder, with variant response to treatment. Triad of cutaneous hyperandrogenism included nodulocystic or severe acne, female pattern hair loss and hirsutism.Aim:The aim of this study is to compare the effectiveness of isotretinoin and cyproterone compound in the treatment of nodulocystic acne, in patients with SAHA syndrome or triad of cutaneous hyperandrogenism.Materials and Methods:30 female patients with SAHA syndrome were divided randomly into two groups. Group A was treated with cyproterone compound from day 5 of menstrual cycle onwards for 3 weeks and a week without it and group B received isotretinoin, with a dose of 0.75 mg/kg per day from the beginning of menses onwards for 4 months. The results were evaluated by a blind dermatologist using Acne Severity Index (ASI) score at baseline and monthly for 4 months.Results:Despite a continuous reduction in ASI score in both the groups, according to both physician (P = 0.63) and patient (P = 0.25) assessment, cyproterone compound was not statistically more effective than conventional treatment of nodulocystic acne at the end of the study. Side-effects were reported in patients in both groups, generally being mild and tolerable except in two subjects.Conclusion:This study indicates that cyproterone compound is not superior to isotretinoin in the treatment of nodulocystic acne in patient with SAHA syndrome or triad of cutaneous hyperandrogenism. Indeed, other studies are needed to evaluate the effect of cyproterone compound (regardless of androgen level) and isotretinoin in subjects with only nodulocystic acne.

Efficacy and Safety of Hormonal Therapies for Acne: A Narrative Review

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Efficacy and Safety of Hormonal Therapies for Acne: A Narrative Review

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2b or Not 2b: How Opposing FGF Receptor Splice Variants Are Blocking Progress in Precision Oncology

“…Expression of FGFR2b-specific ligands FGF7 [ 110 ] and FGF10 [ 59 ] is androgen dependent, with androgen-induced upregulation of FGF10 [ 111 ] being implicated in the pathogenesis of adolescent acne [ 79 ]. In the rare seborrhea-acne-hirsutism-alopecia (SAHA) syndrome [ 112 ], acne responds equally well to isotretinoin (which downregulates FGFR2b) and antiandrogens (which block transactivation of FGF7/10) [ 113 ]. This latter syndromic association between androgens, FGFR2, acne, and alopecia raises the intriguing hypothesis that in addition to FGFR2b-induced inflammatory folliculitis, androgen-dependent FGFR2b proapoptotic signaling could be involved in the pathogenesis of male-pattern baldness.…”

Efficacy and Safety of Hormonal Therapies for Acne: A Narrative Review

“……”

2b or Not 2b: How Opposing FGF Receptor Splice Variants Are Blocking Progress in Precision Oncology

“…Expression of FGFR2b-specific ligands FGF7 [ 110 ] and FGF10 [ 59 ] is androgen dependent, with androgen-induced upregulation of FGF10 [ 111 ] being implicated in the pathogenesis of adolescent acne [ 79 ]. In the rare seborrhea-acne-hirsutism-alopecia (SAHA) syndrome [ 112 ], acne responds equally well to isotretinoin (which downregulates FGFR2b) and antiandrogens (which block transactivation of FGF7/10) [ 113 ]. This latter syndromic association between androgens, FGFR2, acne, and alopecia raises the intriguing hypothesis that in addition to FGFR2b-induced inflammatory folliculitis, androgen-dependent FGFR2b proapoptotic signaling could be involved in the pathogenesis of male-pattern baldness.…”

Efficacy and Safety of Hormonal Therapies for Acne: A Narrative Review

“……”

2b or Not 2b: How Opposing FGF Receptor Splice Variants Are Blocking Progress in Precision Oncology

“…Expression of FGFR2b-specific ligands FGF7 [ 110 ] and FGF10 [ 59 ] is androgen dependent, with androgen-induced upregulation of FGF10 [ 111 ] being implicated in the pathogenesis of adolescent acne [ 79 ]. In the rare seborrhea-acne-hirsutism-alopecia (SAHA) syndrome [ 112 ], acne responds equally well to isotretinoin (which downregulates FGFR2b) and antiandrogens (which block transactivation of FGF7/10) [ 113 ]. This latter syndromic association between androgens, FGFR2, acne, and alopecia raises the intriguing hypothesis that in addition to FGFR2b-induced inflammatory folliculitis, androgen-dependent FGFR2b proapoptotic signaling could be involved in the pathogenesis of male-pattern baldness.…”