Treatment of gram-negative folliculitis with isotretinoin.

The clinical and bacteriological findings are reported in 13 patients with gram-negative folliculitis before, during, and after treatment with isotretinoin (13-cis-retinoic acid). Patients were treated for 14-36 weeks with a daily dose of 0.5-1.5 mg isotretinoin/kg body weight. Inflammatory lesions were counted before and during weeks 2, 4, 8, 12, 16, 20, 24, 28, and 30 of therapy and again up to 172 weeks after cessation of treatment. In all patients there was an impressive improvement in clinical symptoms, especially a decrease in seborrhea and inflammatory lesions. Simultaneously, the gram-negative bacteria disappeared from the facial skin. Full clinical bacteriological remission was achieved in 9 patients within a period of up to 43 months, with minor recurrences of the disease in the remaining 4 patients.