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Oral Isotretinoin (oral + isotretinoin)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Oral Isotretinoin as Part of the Treatment of Cutaneous Aging

DERMATOLOGIC SURGERY, Issue 7 2000
Enrique 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: acne

DERMATOLOGIC THERAPY, Issue 2 2008
A. 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]

Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients

THE JOURNAL OF DERMATOLOGY, Issue 5 2009
Bong Jin HAHM
ABSTRACT Oral isotretinoin is a highly effective agent for the treatment of moderate to severe acne, but ever since oral isotretinoin was introduced as a modality for acne, the relationship between oral isotretinoin therapy and psychiatric problems, especially depression, has been controversial. The purposes of this study were to know the acute effects of oral isotretinoin therapy on psychiatric symptoms and to investigate the relationships among them, which have not been reported in the published work. This cohort study included 38 acne patients who started oral isotretinoin therapy. Individual patients were examined before administering oral isotretinoin and 2 and 8 weeks after commencement. Acne severity was graded using the Leeds revised acne grading system. Acute psychiatric effects of oral isotretinoin were assessed using a questionnaire authorized by two psychiatrists. This questionnaire included assessments of acne-related quality of life (Assessment of the Psychological and Social Effects of Acne [APSEA]), depression (Beck's depression inventory [BDI]), anxiety (Beck's anxiety inventory [BAI]) and psychopathology (Symptomchecklist-90-revised [SCL-90-R]). Acne grading and APSEA showed similar change patterns. Both improved after 8 weeks of oral isotretinoin treatment. On the other hand, the severity of depression decreased after 2 weeks of treatment. A significant correlation was found between BDI and APSEA, but no correlation was found between BDI and acne grade. These results indicate that oral isotretinoin therapy alleviates depressive symptoms. Improvements in depression are directly related to acne-related life quality improvements rather than to improvement in acne grade. [source]

Facial porokeratosis: A series of six patients

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2010
Ericson L Gutierrez
ABSTRACT Porokeratosis is a disorder of epidermal keratinization characterized by annular plaques with an atrophic centre and hyperkeratotic edges, and includes a heterogeneous group of disorders that are mostly inherited in an autosomal dominant fashion. Facial porokeratosis is rare and is not well documented. We present six cases of facial porokeratosis seen over a period of 15 years in a hospital in Lima, Peru. In most of the cases, porokeratosis was found in younger women without any significant past medical history. Oral isotretinoin showed moderate improvement in two of our patients. [source]

Electronic e-isotretinoin prescription chart: Improving physicians' adherence to isotretinoin prescription guidelines

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2009
Mark BY Tang
ABSTRACT Oral isotretinoin is a highly effective treatment for refractory nodulocystic acne. However, it can be associated with serious adverse effects such as teratogenicity and hepatitis. Inadequate cumulative dosing may also result in reduced therapeutic efficacy and higher disease relapse. A preliminary audit had previously revealed a poor and inconsistent adherence to local isotretinoin prescribing guidelines by physicians. To achieve greater than 90% adherence to isotretinoin guidelines for all acne patients prescribed systemic isotretinoin at the National Skin Centre, Singapore, key areas and the reasons for non-adherence were identified. A specifically designed ,one-stop' electronic isotretinoin chart was launched within the electronic medical records (EMR) system to address important safety areas; namely, informed patient consent, pregnancy testing, baseline laboratory tests, and automatic calculation of cumulative and target doses of isotretinoin. Physician adherence to prescribing guidelines improved from a baseline of 50,60% to greater than 90% (range 95,100%) for 30 consecutive months post intervention. The e-isotretinoin chart has resulted in significant improvement in physicians' adherence to isotretinoin prescription guidelines and highlights the utility of EMR technology in influencing safe prescribing behaviour among doctors. [source]

Oral isotretinoin, neuropathy and hypovitaminosis A

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2 2008
F. W. Danby
No abstract is available for this article. [source]

A Case of Multiple Keratoacanthoma Centrifugum Marginatum

DERMATOLOGIC SURGERY, Issue 5 2004
Cristina 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 Option

DERMATOLOGIC SURGERY, Issue 8 2003
Enrique 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 Aging

Is oral isotretinoin the treatment of choice in moderate and severe inflammatory acne vulgaris?

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 9 2007
CD Verros
[source]

Effective treatment of papular acantholytic dyskeratosis with oral isotretinoin

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2007
H Larangeira De Almeida Jr
[source]

A review of the European Directive for prescribing systemic isotretinoin for acne vulgaris

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2006
AM 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]

Clinical and Therapeutic Approach to Childhood Acne: An Update

PEDIATRIC DERMATOLOGY, Issue 4 2009
C. Antoniou M.D., Ph.D.
Childhood acne can be classified in neonatal, infantile, mid-childhood, and prepubertal acne, depending on the age of onset. In this review we will present an update on the clinical approach and therapeutic options when facing prepubertal acne in a child. The use of tetracyclines is contraindicated in children younger than 8 years, and oral isotretinoin is not recommended in children younger than 12 years of age according to the FDA and the European Commission. Nevertheless, there are case reports of 10 patients successfully treated with oral isotretinoin for recalcitrant infantile acne with scarring. Further studies are needed to investigate whether isotretinoin may improve the long-term prognosis of infantile acne, which may be associated with more severe acne in adolescence. [source]

Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients

Successful treatment with oral isotretinoin of acneiform skin lesions associated with cetuximab therapy

BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2005
R. Gutzmer
No abstract is available for this article. [source]

Utility of studying the ocular surface in patients with acne vulgaris treated with oral isotretinoin: a randomized controlled trial

BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2005
P. Aragona
No abstract is available for this article. [source]

Topical aminolaevulinic acid-photodynamic therapy for the treatment of acne vulgaris: a study of clinical efficacy and mechanism of action

BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2004
B. Pollock
Summary Background, ,Acne affects 83,95% of 16-year-olds of both sexes, and many seek help from a clinician. Emerging problems with conventional acne treatments, specifically antibiotic resistance of Propionibacterium acnes and fears over the safety and tolerance of oral isotretinoin, create a demand for novel treatment modalities in acne. Objectives, To study the efficacy of aminolaevulinic acid-photodynamic therapy (ALA-PDT) in the treatment of acne and to identify the mode of action, looking specifically at the effects on surface numbers of P. acnes and on sebum excretion. Methods, ,Ten patients (nine men and one woman, age range 16,40 years) with mild to moderate acne on their backs were recruited. Each patient's back was marked with four 30-cm2 areas of equal acne severity. Each site was then randomly allocated to either ALA-PDT treatment, light alone, ALA alone or an untreated control site. At baseline, numbers of inflammatory and noninflammatory acne lesions were counted, sebum excretion measured by Sebutapes (CuDerm, Dallas, TX, U.S.A.) and surface P. acnes swabs performed. ALA cream (20% in Unguentum Merck) was applied under occlusion to the ALA-PDT and ALA alone sites for 3 h. Red light from a diode laser was then delivered to the ALA-PDT and light alone sites (635 nm, 25 mW cm,2, 15 J cm,2). Each patient was treated weekly for 3 weeks. At each visit acne lesion counts were performed and 3 weeks following the last treatment sebum excretion rates and P. acnes swabs were repeated. Results, There was a statistically significant reduction in inflammatory acne lesion counts from baseline after the second treatment at the ALA-PDT site but not at any of the other sites. No statistically significant reduction in P. acnes numbers or sebum excretion was demonstrated at any sites including the ALA-PDT site. Conclusions, ALA-PDT is capable of clinically improving acne. An alternative mode of action for ALA-PDT other than direct damage to sebaceous glands or photodynamic killing of P. acnes is suggested from the results of this study. [source]