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Safety and efficacy of low-dose isotretinoin in the treatment of moderate to severe acne vulgaris.

Rao PK, Bhat RM, Nandakishore B, Dandakeri S, Martis J, Kamath GH - Indian J Dermatol (2014)

Bottom Line: At the end of the treatment, very good results were observed in 90% of participants.Cheilitis was the most common among the side effects observed and was seen in 98% of the participants.One participant developed vitiligo as a side effect, which is a new finding, and has not reported in literature before.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka, India.

ABSTRACT

Background: Isotretinoin is indicated for moderate to severe cases of acne which are unresponsive to conventional therapy. The classical recommended dose is 0.5 to 1.0 mg/kg/day. As the side effects are dose related, low-dose isotretinoin therapy for acne is an attractive option; however, but little data exists on the safety and efficacy of this strategy.

Materials and methods: In this prospective, non-comparative study, 50 participants, both male and female, having moderate to severe acne vulgaris were enrolled and treated with isotretinoin at a dose of 20 mg/day (approximately 0.3-0.4 mg/kg/day), for a period of 3 months. Participants were evaluated by means of clinical and laboratory investigations before starting isotretinoin. Investigations were repeated at the end of the first and third months following completion of treatment, and participants were followed up for 6 months to look for any relapse.

Results: At the end of the treatment, very good results were observed in 90% of participants. Cheilitis was the most common among the side effects observed and was seen in 98% of the participants. One participant developed vitiligo as a side effect, which is a new finding, and has not reported in literature before. Elevated serum lipid levels were observed in 6% of the participants, and relapse occurred in 4% of the participants over a 6 month follow up period.

Conclusion: Three months of treatment with low-dose isotretinoin (20 mg/day) was found to be effective in the treatment of moderate to severe acne vulgaris, with a low incidence of serious side effects. This dose also was more economical than the higher doses.

No MeSH data available.


Related in: MedlinePlus

(a) Pretreatment photograph (b) Post treatment photograph
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Figure 2: (a) Pretreatment photograph (b) Post treatment photograph

Mentions: Out of the total number of 50 participants, 38 participants (76%) were males and 12 participants (24%) were females. There was an overall male preponderance, the male to female ratio being 3.1:1. Majority of the participants, 35 in number (70%), were in the age group of 21-30 years, the mean age calculated as 26.36 years (Standard Deviation, S.D-5.90). Nodulocystic acne was the most common indication for treatment and was seen in 22 participants (44%), followed by the reason of acne being resistant to treatment in 20 participants (40%), and frequent relapses in 8 participants (16%). On cutaneous assessment, it was found that at week 0, 6 participants (12%) had grade II acne, 28 participants (56%) had grade III acne and 16 participants (32%) had grade IV acne. At the end of 12 weeks, that is, on the completion of treatment, 3 participants (6%) had grade 0 acne, 45 participants (90%) had grade I acne and 2 participants (4%) had grade II acne. During the follow up after 6 months, it was found that 3 participants (6%) had grade 0 acne, 44 participants (88%) had grade I acne, 2 participants (4%) had grade II acne and 1 participant (2%) had grade III acne. Relapse was seen in 2 participants (4%); 1 participant falling in the range of grade I to grade II acne, and 2nd participant in the range of grade II to grade III acne [Table 2]. A significant reduction in the grade of acne was found at the end of treatment, and the reduction in the grade of acne was found to be statistically significant (Friedman Test, χ2 = 146.23, P < 0.0001, Highly Significant) [Table 3]. At the end of 12 weeks post treatment, 3 participants (6%) had 100% lesion clearance (scale 0), 45 participants (90%) had > 75% lesion clearance (scale 1) and 2 participants (4%) had 50-75% lesion clearance (scale 2) [Table 4] [Figures 1a,b and 2a,b].


Safety and efficacy of low-dose isotretinoin in the treatment of moderate to severe acne vulgaris.

Rao PK, Bhat RM, Nandakishore B, Dandakeri S, Martis J, Kamath GH - Indian J Dermatol (2014)

(a) Pretreatment photograph (b) Post treatment photograph
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4037971&req=5

Figure 2: (a) Pretreatment photograph (b) Post treatment photograph
Mentions: Out of the total number of 50 participants, 38 participants (76%) were males and 12 participants (24%) were females. There was an overall male preponderance, the male to female ratio being 3.1:1. Majority of the participants, 35 in number (70%), were in the age group of 21-30 years, the mean age calculated as 26.36 years (Standard Deviation, S.D-5.90). Nodulocystic acne was the most common indication for treatment and was seen in 22 participants (44%), followed by the reason of acne being resistant to treatment in 20 participants (40%), and frequent relapses in 8 participants (16%). On cutaneous assessment, it was found that at week 0, 6 participants (12%) had grade II acne, 28 participants (56%) had grade III acne and 16 participants (32%) had grade IV acne. At the end of 12 weeks, that is, on the completion of treatment, 3 participants (6%) had grade 0 acne, 45 participants (90%) had grade I acne and 2 participants (4%) had grade II acne. During the follow up after 6 months, it was found that 3 participants (6%) had grade 0 acne, 44 participants (88%) had grade I acne, 2 participants (4%) had grade II acne and 1 participant (2%) had grade III acne. Relapse was seen in 2 participants (4%); 1 participant falling in the range of grade I to grade II acne, and 2nd participant in the range of grade II to grade III acne [Table 2]. A significant reduction in the grade of acne was found at the end of treatment, and the reduction in the grade of acne was found to be statistically significant (Friedman Test, χ2 = 146.23, P < 0.0001, Highly Significant) [Table 3]. At the end of 12 weeks post treatment, 3 participants (6%) had 100% lesion clearance (scale 0), 45 participants (90%) had > 75% lesion clearance (scale 1) and 2 participants (4%) had 50-75% lesion clearance (scale 2) [Table 4] [Figures 1a,b and 2a,b].

Bottom Line: At the end of the treatment, very good results were observed in 90% of participants.Cheilitis was the most common among the side effects observed and was seen in 98% of the participants.One participant developed vitiligo as a side effect, which is a new finding, and has not reported in literature before.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka, India.

ABSTRACT

Background: Isotretinoin is indicated for moderate to severe cases of acne which are unresponsive to conventional therapy. The classical recommended dose is 0.5 to 1.0 mg/kg/day. As the side effects are dose related, low-dose isotretinoin therapy for acne is an attractive option; however, but little data exists on the safety and efficacy of this strategy.

Materials and methods: In this prospective, non-comparative study, 50 participants, both male and female, having moderate to severe acne vulgaris were enrolled and treated with isotretinoin at a dose of 20 mg/day (approximately 0.3-0.4 mg/kg/day), for a period of 3 months. Participants were evaluated by means of clinical and laboratory investigations before starting isotretinoin. Investigations were repeated at the end of the first and third months following completion of treatment, and participants were followed up for 6 months to look for any relapse.

Results: At the end of the treatment, very good results were observed in 90% of participants. Cheilitis was the most common among the side effects observed and was seen in 98% of the participants. One participant developed vitiligo as a side effect, which is a new finding, and has not reported in literature before. Elevated serum lipid levels were observed in 6% of the participants, and relapse occurred in 4% of the participants over a 6 month follow up period.

Conclusion: Three months of treatment with low-dose isotretinoin (20 mg/day) was found to be effective in the treatment of moderate to severe acne vulgaris, with a low incidence of serious side effects. This dose also was more economical than the higher doses.

No MeSH data available.


Related in: MedlinePlus