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Isotretinoin
Kinds of Isotretinoin Terms modified by Isotretinoin Selected AbstractsOral Isotretinoin as Part of the Treatment of Cutaneous AgingDERMATOLOGIC SURGERY, Issue 7 2000Enrique Hernandez-Perez MD Background. A number of drugs have been used to prevent aging changes. However, studies of oral isotretinoin, the commonly used acne drug, as an antiaging drug are lacking. Objective. To determine improvement in cutaneous aging utilizing oral isotretinoin combined with different procedures of facial rejuvenation. Methods. Sixty patients ranging in age from 35 to 65 years, in whom additional modalities of rejuvenation were also used, were randomly assigned to receive treatment with oral isotretinoin (10,20 mg three times a week for 2 months, group A). Their results were compared with 60 patients who had undergone the same surgical procedures but with no oral isotretinoin (group B). Results. All patients treated with oral isotretinoin noted improvement in wrinkles, thickness and color of the skin, size of pores, skin elasticity, tone, and reduction in pigmented lesions and mottled hyperpigmentation. A statistically significant difference was found in the improvement of group A (Wilcoxon test <0.01). Using minimal amounts of this drug, the side effects were practically negligible. Conclusion. Utilizing various procedures with oral isotretinoin allowed us to improve the effects of cutaneous aging. Our results using isotretinoin in these cases have been satisfactory. We believe that this is one of the first reports of the use of oral isotretinoin in intrinsic and photoaged skin. [source] Isotretinoin and the controversy of psychiatric adverse effectsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2006Jamison E. Strahan MD Isotretinoin is a synthetic oral retinoid that has great efficacy against severe, recalcitrant, nodulocystic acne. Since its introduction to the market, it has been associated with a variety of adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts. A MEDLINE review was performed to compile all case reports, case series, adverse drug event reportings, and prospective and retrospective studies relating psychiatric adverse events to isotretinoin. In addition, literature linking a biological mechanism for psychiatric adverse events to retinoid signaling pathways was also reviewed. Although a variety of anecdotal and epidemiologic studies are available, the overall lack of concrete scientific data limits any conclusion that can be drawn about a causal relationship between istotretinoin and psychiatric adverse events. Several lines of evidence link retinoid signaling to theorized psychiatric pathogenesis, but are limited in their applicability to adult neurophysiology. [source] Vitamin E does not reduce the side-effects of isotretinoin in the treatment of acne vulgarisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2005Sadiye Kus Background, Isotretinoin is widely used in the treatment of severe, recalcitrant, nodular acne. Mucocutaneous side-effects are seen in the great majority of patients and some of them have elevations in their serum lipid and liver enzyme profiles. Recently, it has been shown that addition of vitamin E decreased the toxicity of high-dose retinoids. Objective, The purpose of this investigator-blinded, randomized study was to assess whether vitamin E would reduce the side-effects of isotretinoin in the treatment of acne vulgaris. Methods, Eighty two patients were randomly assigned to one of two treatment groups with isotretinoin (1 mg/kg/day) alone or combined with vitamin E (800 IU/day). The treatment duration was 16 weeks. Mucocutaneous side-effects such as facial erythema, facial dryness, cheilitis and serum lipid and liver enzyme profiles were assessed. Results, There was no difference in the incidence and severity of side-effects related to isotretinoin between the two treatment groups. Conclusion, Eight hundred IU/day vitamin E did not improve the side-effects of 1 mg/kg/day of isotretinoin in the treatment of acne vulgaris. [source] Poster 2, Acne fulminans: part of the spectrum of SAPHOBRITISH JOURNAL OF DERMATOLOGY, Issue 6 2007S.L. Chua A 13-year-old boy was admitted to hospital with severe back pain and systemic upset. He had commenced isotretinoin 25 mg (0·5 mg kg,1) daily 17 days previously for severe acne unresponsive to oral erythromycin. Isotretinoin was stopped after 4 days due to severe lower back pain. On admission, he was unable to mobilize and the pain was uncontrolled with oral morphine sulphate. Investigations showed leucocytosis and neutrophilia. Magnetic resonance imaging of the vertebrae showed multiple areas of high signal consistent with an inflammatory process such as osteomyelitis. Oral prednisolone 40 mg daily and ibuprofen controlled the pain within 2 days. Sulfasalazine (1 g twice daily) was commenced 10 days later. The re-introduction of isotretinoin 5 mg daily 12 days after admission precipitated severe back pain, necessitating 3 days of intravenous methylprednisolone. The oral prednisolone dose has been reduced over 6 weeks and stopped. The acne is currently controlled with clindamycin, although there is marked scarring. Acne fulminans is a rare condition characterized by sudden onset of severe acne and systemic features such as fever, leucocytosis and arthralgia.1 Osteomyelitic lesions are a recognized feature. In 1987, the term SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome was proposed to describe a clinical entity with skin, joint and bone manifestations. Associated skin conditions include severe acne, psoriasis and palmoplantar pustulosis. Reported sites of osteoarticular involvement include the anterior chest wall, vertebrae, pelvis and mandible.2 Our patient clearly has acne fulminans and fulfils the criteria for SAPHO syndrome. We believe this condition will be increasingly recognized by dermatologists. References 1 Karvonen S. Acne fulminans: report of clinical findings and treatment of twenty-four patients. J Am Acad Dermatol 1993; 28:572,9. 2 Hayem G, Bouchaud-Chabot A, Benali K et al. SAPHO syndrome: a long-term follow-up study of 120 cases. Semin Arthritis Rheum 1999; 29:159,71. [source] The effect of isotretinoin treatment on plasma homocysteine levels in acne vulgarisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2010M. R. Roodsari Summary Isotretinoin has revolutionized the treatment of acne by improving the cosmetic outcome and decreasing the psychological damage. However, use of isotretinoin is associated with significant side-effects such as mucocutaneous involvement, dyslipidaemia and liver dysfunction, as indicated by increases in liver enzymes. The responsible enzyme for homocysteine metabolism, cystathionine-,-synthase, might also be affected by isotretinoin-induced liver dysfunction, which leads to hyperhomocysteinaemia, an independent risk factor for thrombovascular diseases. The aim of this study was to evaluate homocysteine levels and the responsible vitamins for its metabolism in patients with moderate to severe acne vulgaris on isotretinoin treatment, before and after treatment. We found increased level of homocysteine in patients after 2 months of taking isotretinoin. Our findings suggest that isotretinoin may increase the risk of cardiovascular disorders by causing hyperhomocysteinaemia. [source] A Case of Multiple Keratoacanthoma Centrifugum MarginatumDERMATOLOGIC SURGERY, Issue 5 2004Cristina Mangas MD Background. Keratoacanthoma centrifugum marginatum is a rare variety of keratoacanthoma, usually presented and classified as solitary keratoacanthoma. Reported cases of multiple keratoacanthoma centrifugum marginatum are exceptional in the literature. Observations. A 21-year-old man presented for evaluation of erythematous papules and plaques on both legs that had had a peripheral growth over the past year. Clinical and histologic examination showed typical features of keratoacanthoma centrifugum marginatum. Owing to the multiplicity and size of the lesions, treatment with oral isotretinoin was started. It was ineffective. Subsequent treatment with methotrexate combined with oral prednisone led to the regression of all lesions. Conclusions. The exceptional case of a man with multiple keratoacanthoma centrifugum marginatum is reported. Treatment with methotrexate combined with oral prednisone was effective. This case illustrates how some variants of keratoacanthomas do not really fit into the current classification and how complex the treatment of these tumors is. [source] A Percutaneous Approach to Eyebrow Lift: The Salvadorean OptionDERMATOLOGIC SURGERY, Issue 8 2003Enrique Hernandez-Perez MD Background Surgical eyebrow lift can result in a number of complications. A nonsurgical simple method of lifting the brow is presented. Objective To raise the eyebrows using a simple, quick, and noninvasive approach. Methods Twenty-nine patients, 27 women and 2 men, whose ages varied from 24 to 56 years (mean of 32 years) were included in the study. Preoperative and postoperative photographs were taken. In two patients, brow suspension was performed at the time of blepharoplasty. Informed consent was signed by all of the patients. For measuring the degree of satisfaction of the patients, we gave to them a sheet grading it from one to three (with one being the least satisfactory). Local anesthesia (1% lidocaine, 1:400,000 epinephrine), a conveniently sized Keith needle, and prolene 3/0 sutures were used. Results Satisfying results were obtained in all cases. The only problem encountered in two patients was temporary edema, and it settled in a few days. Conclusion This is a very simple, quick, and noncomplicated method of raising the eyebrows. It can be repeated, revised easily, or combined with other modalities, such as peels, topical tretinoin, oral isotretinoin, fat injection, Goretex, and Botox as part of a facial rejuvenation program. [source] Oral Isotretinoin as Part of the Treatment of Cutaneous AgingDERMATOLOGIC SURGERY, Issue 7 2000Enrique Hernandez-Perez MD Background. A number of drugs have been used to prevent aging changes. However, studies of oral isotretinoin, the commonly used acne drug, as an antiaging drug are lacking. Objective. To determine improvement in cutaneous aging utilizing oral isotretinoin combined with different procedures of facial rejuvenation. Methods. Sixty patients ranging in age from 35 to 65 years, in whom additional modalities of rejuvenation were also used, were randomly assigned to receive treatment with oral isotretinoin (10,20 mg three times a week for 2 months, group A). Their results were compared with 60 patients who had undergone the same surgical procedures but with no oral isotretinoin (group B). Results. All patients treated with oral isotretinoin noted improvement in wrinkles, thickness and color of the skin, size of pores, skin elasticity, tone, and reduction in pigmented lesions and mottled hyperpigmentation. A statistically significant difference was found in the improvement of group A (Wilcoxon test <0.01). Using minimal amounts of this drug, the side effects were practically negligible. Conclusion. Utilizing various procedures with oral isotretinoin allowed us to improve the effects of cutaneous aging. Our results using isotretinoin in these cases have been satisfactory. We believe that this is one of the first reports of the use of oral isotretinoin in intrinsic and photoaged skin. [source] New and emerging treatments in dermatology: acneDERMATOLOGIC THERAPY, Issue 2 2008A. Katsambas ABSTRACT:, Topical retinoids, benzoyl peroxide, azelaic acid, and topical and oral antibiotics remain the milestone of treatment for mild to moderate acne vulgaris. Oral isotretinoin is useful for the treatment of severe nodular acne, treatment-resistant acne, and acne with a risk of physical or psychological scarring. Hormonal treatment in female acne is useful in resistant or late-onset acne. With increasing concerns regarding teratogenicity of isotretinoin and increasing antibiotic resistance, there is a clear need for therapeutic alternatives to these long-used treatments. Research in the pathogenesis of acne has allowed for new therapies and future perspectives regarding acne to evolve. They include low-dose long-term isotretinoin regimens, insulin-sensitizing agents, 5,-reductase type 1 inhibitors, topical photodynamic therapy, new combination formulations, dietary interventions, and antiinflammatory agents such as lipoxygenase inhibitors. [source] Treatment of cutaneous T-cell lymphoma with retinoidsDERMATOLOGIC THERAPY, Issue 5 2006Chunlei Zhang ABSTRACT:, Retinoids are biologic regulators of differentiation, proliferation, apoptosis, and immune response. Retinoids (all- trans retinoic acid, 13- cis -retinoic acid, and the synthetic analogs isotretinoin, etretinate, and acitretin) have been used for years as monotherapy and/or in combination for treatment of cutaneous T-cell lymphomas (CTCL). Orally administered bexarotene, the first synthetic highly selective retinoid X receptor retinoid to be approved by the Food and Drug Administration for CTCL, was shown to be active against the cutaneous manifestations of all stages of CTCL. The topical gel formulation was also effective for early cutaneous manifestations of CTCL or as an adjunct to systemic or phototherapy. Use of retinoids in future long-term clinical trials and their eventual application in CTCL regiments will require strategies to decrease the side effects of existing retinoids, identify novel receptor subtype-selective retinoids with better therapeutic index, and explore biologically based synergistic combination therapies with other active agents. [source] Photocarcinogenesis of topical tazarotene and isotretinoin alone and in combination with valproic acid in hairless miceEXPERIMENTAL DERMATOLOGY, Issue 11 2008Catharina M. Lerche Abstract:, Retinoids and the histone deacetylase inhibitor valproic acid have shown anticancer properties, but the photocarcinogenic or photoprotective effect is unclear. Therefore, we investigated whether a topical formulation of valproic acid is photocarcinogenic or photoprotective in hairless female C3.Cg/TifBomTac immunocompetent mice exposed to simulated solar radiation (SSR) and whether valproic acid changes the effect of the retinoids: tazarotene and isotretinoin. The products were applied on the dorsal skin of 400 mice (five times weekly) followed by SSR (three times weekly) 3,4 h after the application. This was performed during 12 months or until death. Tumors appeared sooner in groups treated with tazarotene and isotretinoin compared with that of the group treated with valproic acid and the control group. The present study shows that valproic acid alone is not photocarcinogenic or photoprotective in hairless mice. When valproic acid is combined with tazarotene or isotretinoin, it does not change their photocarcinogenicity significantly. [source] Correspondence: Acute generalized exanthematous pustulosis induced by isotretinoinINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2010Dermatologist, Roberto Rheingantz Da Cunha Filho Master Degree in Health No abstract is available for this article. [source] Unilateral sacroiliitis associated with systemic isotretinoin treatmentINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2010Mauro Barbareschi MD Background, Acne fulminans is the most severe form of inflammatory acne characterized by the acute onset of inflammatory nodules and plaques, most commonly on the chest and the back. The lesions undergo rapid suppuration, leaving ragged hemorrhagic ulcers. Typically, it affects adolescent males with a history of mild to moderate acne. The affected patients often have constitutional symptoms such as fever, malaise, arthralgias, and myalgias. Leukocytosis is commonly associated. Sacroiliitis is reported in 21% of acne fulminans patients in association with arthritis and in a few cases it is reported during isotretinoin treatment, suggesting the drug triggering. Conclusion, We report a case of a young male patient in whom the induction of acne fulminans by systemic isotretinoin was associated with unilateral sacroiliitis. [source] Bone mineral density and bone turnover markers in patients receiving a single course of isotretinoin for nodulocystic acneINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2008Nilgun Solak Tekin Associate Professor Background, High-dose isotretinoin has been reported to have adverse effects on bone mineral density (BMD); however, studies evaluating changes in BMD with isotretinoin therapy at different dosages and with varying treatment durations have produced conflicting results. Objective, To investigate the effect of a standard, single course of isotretinoin therapy on BMD and bone turnover markers in patients with nodulocystic acne. Methods, Thirty-six patients (15 male, 21 female) with severe, recalcitrant, nodulocystic acne and 36 healthy controls (16 male, 20 female) were enrolled in the study. Patients received isotretinoin treatment for 4,6 months until a cumulative dose of 120 mg/kg had been achieved. BMD in the lumbar spine and femur was measured at baseline and at the end of therapy by dual-energy X-ray absorptiometry. Serum calcium, phosphate, parathormone, total alkaline phosphatase, osteocalcin, free deoxypyridinoline, and urinary calcium were also measured before and at the end of treatment. Results, No significant differences were found in lumbar spine and femoral BMD between the patient and control groups at the beginning of the study (P > 0.05), and no statistically significant difference was observed between the BMD values in patients at the beginning vs. the end of treatment (P > 0.05). No statistically significant difference in bone turnover markers was found between patients and controls at the beginning of the study (P > 0.05), and no statistically significant changes in bone turnover markers were observed in patients at the beginning vs. the end of treatment (P > 0.05). Conclusion, A single course of isotretinoin therapy has no clinically significant effect on bone metabolism. [source] Multiple keratoacanthomas in a young woman: report of a case emphasizing medical management and a review of the spectrum of multiple keratoacanthomasINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2007Ron J. Feldman MD A 27-year-old white woman was referred for consultation with regard to the presence of extensive multiple keratotic lesions. She began to develop these lesions at the age of 9 years, with healing of the lesions resulting in scar formation. A biopsy was performed at the age of 16 years, but the patient was unsure of the results. Since then, she had not had any treatment or biopsies, and stated that she had not suffered from any health problems during the intervening period. She was most concerned about the tumors on her heels and soles, which caused difficulty with ambulation. The family history was negative for skin diseases, including melanoma, nonmelanoma skin cancer, psoriasis, and eczema, and positive for Type II diabetes mellitus. A relative reported that the patient's grandfather had similar lesions, but the patient's parents and siblings were healthy. She was married and had one child, a 9-year-old daughter. Her child had no skin lesions. The patient's only medication was Ortho-Tricyclene birth control pills. She had no known drug allergies. Physical examination revealed the presence of multiple lesions on her body (Fig. 1). Her left superior helix contained a well-demarcated, dome-shaped nodule with a rolled, mildly erythematous border with a central hyperkeratotic plug. A similar lesion was present in the scaphoid fossa of the left ear and smaller lesions were scattered on her face. Numerous lesions were present on the arms and legs bilaterally, with the majority of lesions being located on the anterior lower legs. There were also lesions present on the palms and soles. The lesions ranged in size from 5 mm to 3 cm, the largest being a verrucous exophytic nodule on the anterior aspect of her left leg. Overall, there appeared to be two distinct types of lesion. One type appeared round, oval, and symmetric with a central keratotic plug, similar to that on the ear. The other type was larger, more exophytic, and verrucous, including the lesions on the volar surfaces. Also present were numerous, irregularly shaped atrophic scars where previous lesions had healed spontaneously. There were no oral lesions or lesions on her fingernails or toenails, and her teeth and hair were normal. Figure 1. Initial presentation of left ear and anterior legs before treatment A biopsy was obtained from an early lesion on the right dorsal forearm. Histology revealed an exo-/endophytic growth having a central crater containing keratinous material (Fig. 2). The crater was surrounded by markedly hyperplastic squamous epithelium with large squamous epithelial cells having abundant glassy cytoplasm. Some cells were dyskeratotic. Within the dermis was a dense, chiefly mononuclear inflammatory infiltrate. A buttress of epidermis surrounded the crater. The clinical and pathologic data were consistent with keratoacanthomas. Figure 2. Keratoacanthoma exhibiting an exo- and endophytic growth pattern with a central crater containing keratin (hematoxylin and eosin; original magnification, ×40) Initial laboratory screenings revealed elevated triglycerides and total cholesterol, 537 mg/dL (normal, < 150 mg/dL) and 225 mg/dL (normal, < 200 mg/dL), respectively, with all other laboratory results within normal limits. In anticipation of starting oral retinoid therapy for her multiple keratoacanthomas, she was referred to her primary care physician for control of hyperlipidemia. After her lipids had been controlled, she was placed on isotretinoin (Accutane) 40 mg/day. There was some interval improvement with regression of some lesions leaving atrophic scars. She was also started on topical application of tazarotene (Tazorac) for all nonresolving lesions. Possible side-effects from the isotretinoin occurred, including dry mouth and eyes. After 8 months of isotretinoin, the patient was switched to acitretin (Soriatane) 25 mg to determine whether it might have a more beneficial effect on the resistant lesions. Many of the larger lesions regressed leaving atrophic scars. The dose of acitretin was subsequently increased to 35 mg because the lesions on her heel and the ball of her foot persisted. Almost all of the lesions resolved, except those on her feet, which are slowly regressing. Currently, the patient is on a regimen of acitretin 25 mg once a day with tazarotene 0.1% gel applied directly to the few residual keratoacanthomas on her feet, which are slowly improving. [source] Isotretinoin and the controversy of psychiatric adverse effectsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2006Jamison E. Strahan MD Isotretinoin is a synthetic oral retinoid that has great efficacy against severe, recalcitrant, nodulocystic acne. Since its introduction to the market, it has been associated with a variety of adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts. A MEDLINE review was performed to compile all case reports, case series, adverse drug event reportings, and prospective and retrospective studies relating psychiatric adverse events to isotretinoin. In addition, literature linking a biological mechanism for psychiatric adverse events to retinoid signaling pathways was also reviewed. Although a variety of anecdotal and epidemiologic studies are available, the overall lack of concrete scientific data limits any conclusion that can be drawn about a causal relationship between istotretinoin and psychiatric adverse events. Several lines of evidence link retinoid signaling to theorized psychiatric pathogenesis, but are limited in their applicability to adult neurophysiology. [source] Vitamin E does not reduce the side-effects of isotretinoin in the treatment of acne vulgarisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2005Sadiye Kus Background, Isotretinoin is widely used in the treatment of severe, recalcitrant, nodular acne. Mucocutaneous side-effects are seen in the great majority of patients and some of them have elevations in their serum lipid and liver enzyme profiles. Recently, it has been shown that addition of vitamin E decreased the toxicity of high-dose retinoids. Objective, The purpose of this investigator-blinded, randomized study was to assess whether vitamin E would reduce the side-effects of isotretinoin in the treatment of acne vulgaris. Methods, Eighty two patients were randomly assigned to one of two treatment groups with isotretinoin (1 mg/kg/day) alone or combined with vitamin E (800 IU/day). The treatment duration was 16 weeks. Mucocutaneous side-effects such as facial erythema, facial dryness, cheilitis and serum lipid and liver enzyme profiles were assessed. Results, There was no difference in the incidence and severity of side-effects related to isotretinoin between the two treatment groups. Conclusion, Eight hundred IU/day vitamin E did not improve the side-effects of 1 mg/kg/day of isotretinoin in the treatment of acne vulgaris. [source] Extranodal Rosai- n disease with cutaneous, ophthalmic and laryngeal involvement: report of a case treated with isotretinoinINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2002Lih-Yuan Chang MD First page of article [source] Severe ulcerated ,bodybuilding acne' caused by anabolic steroid use and exacerbated by isotretinoinINTERNATIONAL WOUND JOURNAL, Issue 3 2010Verena Voelcker We report a case of severe "bodybuilding acne" in a 22-year-old patient. Treatment with isotretinoin paradoxically led to exaceibation and occurrence of pyogenic granuloma-like lesions. [source] Successful treatment of recurrent vulvar intraepithelial neoplasia resistant to interferon and isotretinoin with cidofovirJOURNAL OF MEDICAL VIROLOGY, Issue 2 2001Suphannee Koonsaeng Abstract Vulvar intraepithelial neoplasias are difficult to eradicate completely without extensive surgical intervention. Cidofovir, a deoxycytidine monophosphate analog, may have a therapeutic role in this disease. A 43-year-old woman with a 20-year history of genital warts presented with extensive vulvar intraepithelial neoplasia III, and refused surgical resection. Topical cidofovir 1% in Beeler base completely eradicated the lesion. Successive treatment applications, however, were necessary. Cidofovir is a promising topical antiviral compound for HPV induced vulvar intraepithelial neoplasia. J. Med. Virol. 64:195,198, 2001. © 2001 Wiley-Liss, Inc. [source] Depressive symptoms and suicidal ideation during isotretinoin treatment: a 12-week follow-up study of male Finnish military conscriptsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 11 2009LMH Rehn Abstract Objective, To investigate the putative association between isotretinoin treatment and depressive symptoms or suicidal ideation among Finnish male military conscripts. Methods, Consecutive acne patients were enrolled into an uncontrolled, prospective 12-week follow-up study conducted at the Central Military Hospital, Helsinki, Finland. Of the 135 patients prescribed isotretinoin, 126 (93.3%) completed the follow-up. Depression and suicidal ideation were investigated with the Beck Depression Inventory (BDI) at baseline, weeks 4,6, and weeks 10,12. Results, BDI mean score was low at baseline and declined further significantly (p < 0.001) during the follow-up from 3.0 (SD 3.948) to 1.8 (SD 3.783) among patients on isotretinoin. Moreover, the proportion of patients with clinically significant depressive symptoms (BDI , 10) declined non-significantly from 7.1 % to 3.2 %. Suicidal ideation was reported by 17 (13.5 %) patients at baseline and 9 (7.1%) patients at the end of the follow-up (NS). During the follow-up, one non-depressed patient attempted suicide while intoxicated by alcohol. Conclusion, On group level, isotretinoin seems not to be typically associated with treatment-emergent depression or suicidal ideation among young men. However, the possibility that individual patients may be susceptible for mood effects of isotretinoin as a rare idiosyncratic reaction can not be excluded. [source] Use of isotretinoin for photoagingJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2009B Moncada [source] Current topical and systemic approaches to treatment of rosaceaJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2009HC Korting Abstract Rosacea is a common, often overlooked, chronic facial dermatosis characterized by intermittent periods of exacerbation and remission. Clinical subtypes and grading of the disease have been defined in the literature. On the basis of a genetic predisposition, there are several intrinsic and extrinsic factors possibly correlating with the phenotypic expression of the disease. Although rosacea cannot be cured, there are several recommended treatment strategies appropriate to control the corresponding symptoms/signs. In addition to adequate skin care, these include topical and systemic medications particularly suitable for the papulopustular subtype of rosacea with moderate to severe intensity. The most commonly used and most established therapeutic regimens are topical metronidazole and topical azelaic acid as well as oral doxycycline. Conventionally, 100,200 mg per day have been used. Today also a controlled release formulation is available, delivering 40 mg per day using non-antibiotic, anti-inflammatory activities of the drug. Anti-inflammatory dose doxycycline in particular allows for a safe and effective short- and long-term therapy of rosacea. Topical metronidazole and topical azelaic acid also appear to be safe and effective for short-term use. There are indications that a combined therapy of anti-inflammatory dose doxycycline and topical metronidazole could possibly have synergy effects. Further interesting therapy options for the short- and long-term therapy of rosacea could be low-dose minocycline and isotretinoin; however, too little data are available with regard to the effectiveness, safety, optimal dosage and appropriate length of treatment for these medications to draw final conclusions. Conflicts of interest None declared. [source] Systemic low-dose isotretinoin maintains remission status in epidermodysplasia verruciformisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2008E Rallis [source] Is oral isotretinoin the treatment of choice in moderate and severe inflammatory acne vulgaris?JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 9 2007CD Verros [source] Effective treatment of papular acantholytic dyskeratosis with oral isotretinoinJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2007H Larangeira De Almeida Jr [source] A review of the European Directive for prescribing systemic isotretinoin for acne vulgarisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2006AM Layton Abstract Since the introduction of generic oral isotretinoin there have been discussions around harmonizing the summary of product characteristics of each formulation. As a result of these discussions, a European Directive concerned with the prescribing of oral isotretinoin has been introduced and the FDA (Food and Drugs Administration) has recently implemented new regulations. The aims of this article are to summarize the history of the processes involved, outline the new recommendations and discuss the impact of these changes in clinical practice. [source] Rosacea and its management: an overviewJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2005AK Gupta ABSTRACT Background, Rosacea is a chronic inflammatory disorder that affects 10% of the population. The prevalence of rosacea is highest among fair-skinned individuals, particularly those of Celtic and northern European descent. Since a cure for rosacea does not yet exist, management and treatment regimens are designed to suppress the inflammatory lesions, erythema, and to a lesser extent, the telangiectasia involved with rosacea. Objectives, This review outlines the treatment options that are available to patients with rosacea. Methods, Published literature involving the treatment or management of rosacea was examined and summarized. Results, Patients who find that they blush and flush frequently, or have a family history of rosacea are advised to avoid the physiological and environmental stimuli that can cause increased facial redness. Topical agents such as metronidazole, azelaic acid cream or sulfur preparations are effective in managing rosacea. Patients who have progressed to erythematotelangiectatic and papulopustular rosacea may benefit from the use of an oral antibiotic, such as tetracycline, and in severe or recalcitrant cases, isotretinoin to bring the rosacea flare-up under control. Treatment with a topical agent, such as metronidazole, may help maintain remission. Patients with ocular involvement may benefit from a long-term course of an antibiotic and the use of metronidazole gel. A surgical alternative, laser therapy, is recommended for the treatment of telangiectasias and rhinophyma. Patients with distraught feelings due to their rosacea may consider cosmetic camouflage to cover the signs of rosacea. Conclusions, With the wide variety of oral and topical agents available for the effective management of rosacea, patients no longer need to feel self-conscious because of their disorder. [source] Cutis verticis gyrata secondary to acne scleroticans capitisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2004J Ulrich ABSTRACT We report the case of a 35-year-old patient with secondary cutis verticis gyrata (CVG) that histologically presented as acne scleroticans capitis. Clinically, the diagnosis of acne conglobata was made. The CVG developed under systemic corticosteroid treatment of an ulcerative colitis. Corticosteroids were discontinued and a therapeutic attempt was made with isotretinoin. Although under this treatment the conglobate acne healed, the CVG remained unaltered. Dermatosurgical intervention by a scalp reduction plasty finally resulted in a marked improvement of symptoms and acceptable cosmetic outcome. [source] Dapsone in rosacea fulminansJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2001G Bormann Abstract Rosacea fulminans is a rare disease with female predominance characterized by abrupt onset of pustules, papules, and confluent nodules on the face. The conventional treatment consists of systemic glucocorticoids and isotretinoin. We present the case of a 56-year-old woman with a marked facial papulopustular eruption that had followed an initial period of severe seborrhoea. Conventional treatment produced no clear improvement. Dapsone treatment achieved complete healing in 5 weeks. [source] | ||||||||||