A Kumar1, V K Kumar2. 1. Classified Specialist (Dermatology & Venereology), Military Hospital, Ambala Cantt-01. 2. Senior Advisor (Pathology), Command Hospital (EC), Kolkata-27.
Abstract
BACKGROUND: Isotretinoin, an oral retinoid, has been utilized to achieve long term remissions in cases of recalcitrant acne. In the conventional dosage schedule, the use of oral isotretinoin has been limited by the occurrence of biochemical abnormalities such as hypertriglyceridaemia and impaired liver function tests and radiological changes consistent with diffuse idiopathic skeletal hyperostosis. Low-dose intermittent regimen of oral isotretinoin has been evolved as a cost effective alternative to the conventional dosage regimen in cases of acne. This study addresses the issue of adverse effects of low-dose intermittent isotretinoin and the safety of this regimen. METHODS: A total of 60 cases of recalcitrant acne were included in the study. Baseline haematological, biochemical and radiological investigations were carried out. Low-dose intermittent isotretinoin was instituted in a dose of 0.5 mg/kg/day for one week in every four weeks for six months. The investigations were repeated at the end of six months therapy. RESULT: High triglyceride levels occurred in 5% of cases whereas impaired liver function tests and skeletal hyperostosis of the spine were not observed in any case after low-dose intermittent isotretinoin. CONCLUSION: The low-dose intermittent regimen in cases of acne may be utilized to limit the systemic toxicity of oral isotretinoin.
BACKGROUND:Isotretinoin, an oral retinoid, has been utilized to achieve long term remissions in cases of recalcitrant acne. In the conventional dosage schedule, the use of oral isotretinoin has been limited by the occurrence of biochemical abnormalities such as hypertriglyceridaemia and impaired liver function tests and radiological changes consistent with diffuse idiopathic skeletal hyperostosis. Low-dose intermittent regimen of oral isotretinoin has been evolved as a cost effective alternative to the conventional dosage regimen in cases of acne. This study addresses the issue of adverse effects of low-dose intermittent isotretinoin and the safety of this regimen. METHODS: A total of 60 cases of recalcitrant acne were included in the study. Baseline haematological, biochemical and radiological investigations were carried out. Low-dose intermittent isotretinoin was instituted in a dose of 0.5 mg/kg/day for one week in every four weeks for six months. The investigations were repeated at the end of six months therapy. RESULT: High triglyceride levels occurred in 5% of cases whereas impaired liver function tests and skeletal hyperostosis of the spine were not observed in any case after low-dose intermittent isotretinoin. CONCLUSION: The low-dose intermittent regimen in cases of acne may be utilized to limit the systemic toxicity of oral isotretinoin.
Authors: Nicolas Rodondi; Roger Darioli; Albert-Adrien Ramelet; Daniel Hohl; Vincent Lenain; Jean Perdrix; Vincent Wietlisbach; Walter F Riesen; Thomas Walther; Laurent Medinger; Pascal Nicod; Béatrice Desvergne; Vincent Mooser Journal: Ann Intern Med Date: 2002-04-16 Impact factor: 25.391
Authors: J I Ross; A M Snelling; E Carnegie; P Coates; W J Cunliffe; V Bettoli; G Tosti; A Katsambas; J I Galvan Peréz Del Pulgar; O Rollman; L Török; E A Eady; J H Cove Journal: Br J Dermatol Date: 2003-03 Impact factor: 9.302