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One hundred patients clinically diagnosed with acne vulgaris were treated with isotretinoin at a dosage of at least 100/mg/kg cumulatively to determine the incidence, severity, and duration of side effects seen during isotretinoin treatment. The most frequent side effect was mucocutaneous findings while the plasma triglyceride levels increased moderately. The improvement rate was 91%.
Acne vulgaris is a chronic inflammatory disease with a multifactorial etiology involving the pilosebaceous unit. Although it is commonly accepted to be a disease of adolescence, it can also be seen in the neonatal, infantile, prepubertal, and adult periods when the sebaceous glands are active. Increased incidence is seen in 14 to 17-year-old females and 16 to 19-year-old males, and it is more frequent and more severe in males (Cunliffe & Simpson, 1998). Increased sebum secretion, abnormal follicular keratinization, microbial colonization, and inflammation are thought to be involved in the pathogenesis of acne. A drug combination that aims to correct the abnormal keratinization and decrease P. Acnes proliferation is therefore adequate in most patients with acne. Repressing sebum production is suggested for more serious conditions not responding to this treatment (Strauss & Thibautat, 1999).
Isotretinoin is the only medication with an effect on all factors involved in the pathogenesis of acne (Cunliffe et al., 1997). It markedly decreases the dimensions and sebum production of the sebaceous glands, reverses the effect of androgens on these structures, thus changing keratinocyte maturation and adhesion, and represses the inflammatory component of acne and comedone production (Cooper, 1997; Ellis & Krach, 2001). After a month of isotretinoin treatment, sebum production, P. acnes incidence, and comedogenesis decreases by 80% (Leyden, Mcginley, & Foglia, 1986; Strauss, Stranieri, Farrell, & Downing, 1980). This medication has been revolutionary, especially for treating nodulocystic acne, but the known severe side effects may limit its use by the physician or the patient. The aim of this study was to investigate the incidence and severity of isotretinoin treatment side effects.
Material and Methods
One hundred patients with nodular, nodulocystic, or moderate acne seen in an outpatient department were included in the study. Among the group with moderate acne, only those patients who had not responded to 6 months of antibiotics and topical treatment or who had responded but showed recurrence when the...