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Leducq S, Poizeau F, Chaby G, Tannous J, Ballanger-Desolneux F, Baubion E, Bertolotti A, Cogrel O, Droitcourt C, Garnier V, Gautier S, Hefez L, Hotz C, Jonville-Béra AP, Jouan N, Mahé A, Mahé E, Martinho G, Micallef J, Puszkarek T, Dupin N, Ly S, Beylot-Barry M, Corgibet F, Guillot B, Chosidow O. Isotretinoin: Past, present and future. A French perspective. Ann Dermatol Venereol 2024; 151:103244. [PMID: 38848643 DOI: 10.1016/j.annder.2023.103244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/22/2023] [Accepted: 11/06/2023] [Indexed: 06/09/2024]
Affiliation(s)
- S Leducq
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Tours, 37000 Tours, France.
| | - F Poizeau
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Rennes, 35000 Rennes, France
| | - G Chaby
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Amiens, 80000 Amiens, France; Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France
| | - J Tannous
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France
| | - F Ballanger-Desolneux
- Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Bordeaux, 33000 Bordeaux, France
| | - E Baubion
- Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU de Martinique, 97261 Fort de France, France
| | - A Bertolotti
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; INSERM CIC1410, Service de maladies infectieuses-dermatologie, CHU de la Réunion, Site Sud, 97448 Saint-Pierre, France
| | - O Cogrel
- Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Bordeaux, 33000 Bordeaux, France
| | - C Droitcourt
- Service de Dermatologie, CHU Rennes, 35000 Rennes, France; Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - V Garnier
- Pharmacie Garnier, 30840 Meynes, France
| | - S Gautier
- Pharmacologie Inserm U1171, Université de Lille, Centre régional de pharmacovigilance, CHU, 59000 Lille, France
| | - L Hefez
- Service de Dermatologie, Grand hôpital de l'Est Francilien, 77600 Jossigny, France
| | - C Hotz
- Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Équipe transverse, Centre Hospitalier Jacques Puel, 12000 Rodez, France
| | - A-P Jonville-Béra
- Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance, CHRU Tours, 37044 Tours, France
| | - N Jouan
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Cabinet de Dermatologie, 29200 Brest, France
| | - A Mahé
- Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CH Colmar, 68000 Colmar, France
| | - E Mahé
- Service de Dermatologie, CH Argenteuil, 78018 Argenteuil, France
| | - G Martinho
- Délégué Général, Fédération Française de la Peau, 75012 Paris, France
| | - J Micallef
- Service de Pharmacologie et pharmacovigilance, CHU Marseille, 13009 Marseille, France
| | - T Puszkarek
- Université de Bretagne Occidentale, 29200 Brest, France
| | - N Dupin
- Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - S Ly
- Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Bordeaux, 33000 Bordeaux, France; Cabinet de Dermatologie, 33170 Gradignan, France
| | - M Beylot-Barry
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Bordeaux, 33000 Bordeaux, France
| | - F Corgibet
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Cabinet de Dermatologie, 21000 Dijon, France
| | - B Guillot
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Université de Montpellier, 34000 Montpellier, France
| | - O Chosidow
- Centre de Preuves de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Groupe DEFI de la Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Consultation dermatoses faciales, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, 75013 Paris, France
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Chiriac A, Wollina U. Pediatric Dermatitis Seborrhoica - A Clinical and Therapeutic Review. Indian Dermatol Online J 2024; 15:383-391. [PMID: 38845676 PMCID: PMC11152465 DOI: 10.4103/idoj.idoj_593_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/21/2023] [Accepted: 10/24/2023] [Indexed: 06/09/2024] Open
Abstract
Pediatric dermatitis seborrhoica (DS) is a common inflammatory disorder of infancy and adolescence distinct from atopic dermatitis. We performed a narrative review on clinical and therapeutic aspects of the disease. The prevalence varies geographically and can reach up to 10%. There is a slight male predominance. Although etiopathology is not well known, both endogenous and exogenous factors contribute. Skin microbiome and its interaction with sebaceous gland function is crucial. The inflammatory pathways include innate immune function and skin barrier disturbances. Malassezia spp. and certain bacteria are increased in lesional skin. DS develops in different clinical subtypes, from localized cephalic to disseminated disease with a risk of erythroderma and eczema herpeticatum. Treatment consists of skin care and topical and rarely systemic medical therapy. Cornerstones of treatment are antifungals and mild corticosteroids. Targeted treatment is on the horizon. Pediatric DS is a common disorder important in the differential diagnosis of skin problems in infants and and children. Due to better understanding of its pathogenesis, new treatment options are developed.
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Affiliation(s)
- Anca Chiriac
- Department of Dermatology, Nicolina Medical Center, Iasi, Romania
- Apollonia University, Iasi, Romania
- Romanian Academy, P. Poni Institute of Macromolecular Chemistry, Iasi, Romania
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
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3
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Paichitrojjana A, Paichitrojjana A. Oral Isotretinoin and Its Uses in Dermatology: A Review. Drug Des Devel Ther 2023; 17:2573-2591. [PMID: 37649956 PMCID: PMC10464604 DOI: 10.2147/dddt.s427530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023] Open
Abstract
In 1982, the Food and Drug Administration (FDA) of the United States of America approved isotretinoin (13-cis-retinoic acid), a retinoid derivative of vitamin A, to treat severe recalcitrant acne vulgaris. Apart from its prescribed use for severe acne, evidence suggests that isotretinoin is commonly used off-label to treat mild-to-moderate acne, inflammatory skin conditions, genodermatoses, skin cancer, and other skin disorders. This is due to its anti-inflammatory, immunomodulatory, and antineoplastic properties. Some "off-label" use is successful, while others are ineffective. Therefore, this information is essential to clinicians for deciding on the appropriate use of isotretinoin. In this article, we aim to review the most updated evidence-based data about the use of oral isotretinoin in dermatology.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
| | - Anand Paichitrojjana
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Yanfei Z, Xiaoying N, Dingwei Z, Wei W, Jianwen R. Efficacy and safety of oral isotretinoin in the treatment of moderate to severe seborrheic dermatitis: a retrospective study. Int J Dermatol 2023; 62:759-763. [PMID: 36789995 DOI: 10.1111/ijd.16582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/01/2022] [Accepted: 12/28/2022] [Indexed: 02/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Seborrheic dermatitis is a common, chronic, and recurrent inflammatory skin disease. There are few studies on oral isotretinoin in the treatment of seborrheic dermatitis. The aim of this research was to analyze the efficacy and safety of oral isotretinoin in the treatment of patients with moderate to severe seborrheic dermatitis. METHODS This was a retrospective study. All included patients were diagnosed as moderate to severe seborrheic dermatitis and treated with oral isotretinoin from January 2019 to December 2020. Symptom Scale of Seborrheic Dermatitis (SSSD) was used to evaluate the overall severity status of disease. RESULTS A total of 48 patients with moderate to severe seborrheic dermatitis were enrolled, of which 26 patients were treated with oral isotretinoin at a dose of 20 mg/day, and 22 patients were treated with oral isotretinoin at a dose of 10 mg/day. The duration of treatment was 2.42 ± 0.98 months (range: 2-6 months). The absolute SSSD values were 10.63 ± 1.02 for all 48 patients, 10.95 ± 1.15 and 10.30 ± 1.11 for patients with a dose of 20 and 10 mg/day, respectively. At the endpoint, there were no significant difference in SSSD values between the two groups (2.21 ± 0.24 vs. 2.35 ± 0.46, P = 0.18). The patients were satisfied with the two treatment schemes, and the difference was not statistically significant (P = 0.78). The most common side effect was cheilitis; however, no serious adverse events occurred in either group. CONCLUSIONS When considering efficacy and safety, oral isotretinoin can be used to treat patients with moderate to severe seborrheic dermatitis.
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Affiliation(s)
- Zhang Yanfei
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ning Xiaoying
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhang Dingwei
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wang Wei
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ren Jianwen
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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5
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Ou-Yang XL, Zhang D, Wang XP, Yu SM, Xiao Z, Li W, Li CM. Nontargeted metabolomics to characterize the effects of isotretinoin on skin metabolism in rabbit with acne. Front Pharmacol 2022; 13:963472. [PMID: 36120319 PMCID: PMC9470959 DOI: 10.3389/fphar.2022.963472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. This study aimed to explore the pathogenesis of acne and the therapeutic mechanism of isotretinoin from the metabolic perspective in coal tar-induced acne in rabbits.Methods: Ultra-high performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UHPLC-qTOF-MS) based metabolomics was used to identify skin metabolites in groups C (blank control), M (model group) and T (isotretinoin group). Multivariate statistical analysis was used to process the metabolomics data.Results: 98 differential metabolites in group C and group M were identified. The highest proportion of differential metabolites were organic acids and derivatives, lipid metabolites, organic heterocyclic compounds, and nucleoside metabolites. The most significant metabolic pathways included protein digestion and absorption, central carbon metabolism in cancer, ABC transporters, aminoacyl-tRNA biosynthesis, biosynthesis of amino acids, and sphingolipid signaling pathway. Isotretinoin treatment normalized eight of these metabolites.Conclusions: Our study will help to further elucidate the pathogenesis of acne, the mechanism of isotretinoin at the metabolite level, and identify new therapeutic targets for treating acne.
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Affiliation(s)
- Xiao-Liang Ou-Yang
- Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Deng Zhang
- Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Xiu-Ping Wang
- Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Si-Min Yu
- Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Zhen Xiao
- Department of Dermatology, Taiyuan Central Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China
| | - Wei Li
- Department of Plastic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Chun-Ming Li
- Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
- *Correspondence: Chun-Ming Li,
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Gencebay G, Aşkın Ö, Serdaroğlu S. Evaluation of the changes in sebum, moisturization and elasticity in acne vulgaris patients receiving systemic isotretinoin treatment. Cutan Ocul Toxicol 2021; 40:140-144. [PMID: 33978534 DOI: 10.1080/15569527.2021.1922434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM The aim of this study was to determine the change in facial skin sebum, hydration and elasticity of acne vulgaris patients after being treated with systemic isotretinoin. METHOD Patients who were diagnosed with acne vulgaris and who received systemic isotretinoin treatment for 6 months in Cerrahpaşa Medical Faculty Department of Dermatology between June 2012 and May 2017 were included in this study. The sebum, hydration and elasticity of the skin were measured non-invasively with a device called "Soft Plus Skin Analyses System" before treatment and 6 months after treatment. The relationship between the pre-treatment and post-treatment values were evaluated statistically. 35 adult patients (20 female, 15 male) who were diagnosed with acne vulgaris and who received systemic isotretinoin treatment for 6 months. RESULTS The pre-treatment sebum value for both sexes ranged between 5 and 100 and the mean value was calculated as 75.8 ± 28.0. The post-treatment sebum values ranged between 1 and 98 and the mean value was calculated as 48.4 ± 31.8. The difference between the pre-treatment and post-treatment values was statistically significant, p < 0.001. The decline in sebum value after treatment was 36%. The pre-treatment hydration values ranged between 9 and 77.5 and the mean was 34.6 ± 14.6. The post treatment hydration values ranged between 4.8 and 100 and the mean was calculated as 62.4 ± 28.6. The difference between the pre-treatment and post-treatment hydration values were statistically significant, p < 0.001. The post-treatment increase in hydration was 79%. The pre-treatment skin elasticity ranged between 28 and 50; the mean was 40.4 ± 5.5. The post-treatment elasticity values ranged between 20 and 50; and the mean was 37.5 ± 8.2. However, the difference was not statistically significant (p = 0.1). CONCLUSION With this study, it was concluded that, systemic isotretion leads to a 36% decline in skin sebum values and a 79% increase in the skin hydration. However, the change in skin elasticity was not statistically significant. Furthermore, the changes in sebum and skin hydration did not lead to a change in skin elasticity.
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Affiliation(s)
- Güllü Gencebay
- Şırnak Goverment Hospital Dermatology Department, Şırnak, Turkey
| | - Özge Aşkın
- Cerrahpaşa Medical Faculty, Dermatology Department, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Server Serdaroğlu
- Cerrahpaşa Medical Faculty, Dermatology Department, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Bagatin E, Costa CS, Rocha MADD, Picosse FR, Kamamoto CSL, Pirmez R, Ianhez M, Miot HA. Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology. An Bras Dermatol 2020; 95 Suppl 1:19-38. [PMID: 33036809 PMCID: PMC7772596 DOI: 10.1016/j.abd.2020.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/11/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Isotretinoin is a synthetic retinoid, derived from vitamin A, with multiple mechanisms of action and highly effective in the treatment of acne, despite common adverse events, manageable and dose-dependent. Dose-independent teratogenicity is the most serious. Therefore, off-label prescriptions require strict criteria. OBJECTIVE To communicate the experience and recommendation of Brazilian dermatologists on oral use of the drug in dermatology. METHODS Eight experts from five universities were appointed by the Brazilian Society of Dermatology to develop a consensus on indications for this drug. Through the adapted DELPHI methodology, relevant elements were listed and an extensive analysis of the literature was carried out. The consensus was defined with the approval of at least 70% of the experts. RESULTS With 100% approval from the authors, there was no doubt about the efficacy of oral isotretinoin in the treatment of acne, including as an adjunct in the correction of scars. Common and manageable common adverse events are mucocutaneous in nature. Others, such as growth retardation, abnormal healing, depression, and inflammatory bowel disease have been thoroughly investigated, and there is no evidence of a causal association; they are rare, individual, and should not contraindicate the use of the drug. Regarding unapproved indications, it may represent an option in cases of refractory rosacea, severe seborrheic dermatitis, stabilization of field cancerization with advanced photoaging and, although incipient, frontal fibrosing alopecia. For keratinization disorders, acitretin performs better. In the opinion of the authors, indications for purely esthetic purposes or oil control are not recommended, particularly for women of childbearing age. CONCLUSIONS Approved and non-approved indications, efficacy and adverse effects of oral isotretinoin in dermatology were presented and critically evaluated.
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Affiliation(s)
- Ediléia Bagatin
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | - Fabíola Rosa Picosse
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Rodrigo Pirmez
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mayra Ianhez
- Department of Tropical Medicine and Dermatology, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Hélio Amante Miot
- Department of Dermatology, Faculdade de Ciências Médicas e Biológicas de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
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Isotretinoin-Induced Delusional Disorder, Somatic Subtype. Case Rep Dermatol Med 2020; 2020:8853167. [PMID: 32774942 PMCID: PMC7399729 DOI: 10.1155/2020/8853167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 11/30/2022] Open
Abstract
Isotretinoin, an active form of vitamin A, is the drug of last resort for the treatment of severe acne. Depression, suicidal ideation, and psychosis are among the most well-documented psychiatric side effects. Here, we report a case of isotretinoin-induced psychosis, which was diagnosed as delusional disorder somatic subtype, in a young male in the absence of any prodromal symptoms, previous psychiatric history, or family history of mental illness. The onset of psychosis was in the context of a dosage increase from 40 mg/day to 80 mg/day. Isotretinoin was discontinued, and the patient showed improvement on low-dose quetiapine.
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9
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Abdelmaksoud A, Lotti T, Anadolu R, Goldust M, Ayhan E, Dave DD, Vestita M, Ebik B, Gupta M. Low dose of isotretinoin: A comprehensive review. Dermatol Ther 2020; 33:e13251. [PMID: 32022958 DOI: 10.1111/dth.13251] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/04/2020] [Accepted: 02/03/2020] [Indexed: 12/21/2022]
Abstract
Isotretinoin is a first-generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti-inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date-unlimited PubMed search, from inception till December 2019, using the following search terms: "low-dose isotretinoin" and "dermatology," "isotretinoin and safety," "isotretinoin, off-label uses," "isotretinoin and male fertility," "isotretinoin, iPLEDGE system," aiming to deliver a therapeutic update relevant to clinical practice. All English-language articles were considered with no limitation based on the articles' type. Low-dose isotretinoin is not limited to old and novel dermatological conditions, but also showed promising results in the field of infertility and safety in the field of gastroenterology. We also highlight on the safety profile of the drug and experts' recommendations to enhance safety measures to decrease fetal risk while on isotretinoin.
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Affiliation(s)
- Ayman Abdelmaksoud
- Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt
| | - Torello Lotti
- Department of Dermatology, University of Rome "G.Marconi", Rome, Italy
| | - Rana Anadolu
- Department of Dermatology, Venerology and Dermatopathology, International Dermatology, Dermatopathology, Esthetics and Anti-aging Academy (IDEA), Istanbul, Turkey.,Dermatology Clinic, Ankara, Turkey.,Faculty of Medicine, Department of Dermatology, Ankara University, Ankara, Turkey
| | - Mohamed Goldust
- University of Rome G. Marconi, Rome, Italy.,Department of Dermatology, University Medical Center Mainz, Mainz, Germany.,Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Erhan Ayhan
- Department of Dermatology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | | | - Michelangelo Vestita
- Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.,Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Berat Ebik
- Division of Gastroenterology Diyarbakir, Dicle University Faculty of Medicine, Kıtılbıl, Turkey
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Clayton R, Göbel K, Niessen C, Paus R, Steensel M, Lim X. Homeostasis of the sebaceous gland and mechanisms of acne pathogenesis. Br J Dermatol 2019; 181:677-690. [DOI: 10.1111/bjd.17981] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 12/13/2022]
Affiliation(s)
- R.W. Clayton
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Centre for Dermatology Research University of Manchester, and NIHR Manchester Biomedical Research Centre Manchester U.K
| | - K. Göbel
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Department of Dermatology Cologne Excellence Cluster on Stress Responses in Aging Associated Diseases (CECAD), and Centre for Molecular Medicine Cologne The University of Cologne Germany
| | - C.M. Niessen
- Department of Dermatology Cologne Excellence Cluster on Stress Responses in Aging Associated Diseases (CECAD), and Centre for Molecular Medicine Cologne The University of Cologne Germany
| | - R. Paus
- Centre for Dermatology Research University of Manchester, and NIHR Manchester Biomedical Research Centre Manchester U.K
- Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL U.S.A
| | - M.A.M. Steensel
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Lee Kong Chian School of Medicine Nanyang Technological University Singapore
| | - X. Lim
- Skin Research Institute of Singapore Agency for Science, Technology and Research (A*STAR) Singapore
- Lee Kong Chian School of Medicine Nanyang Technological University Singapore
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11
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Bagatin E, de Freitas THP, Machado MCR, Ribeiro BM, Nunes S, da Rocha MAD. Adult female acne: a guide to clinical practice. An Bras Dermatol 2019; 94:62-75. [PMID: 30726466 PMCID: PMC6360964 DOI: 10.1590/abd1806-4841.20198203] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 06/10/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Acne in women is often associated with anxiety and depression, and may persist from adolescence as well as manifest for the first time in adulthood. Genetic and hormonal factors contribute to its etiopathogenesis, and maintenance treatment is required, usually for years, due to its clinical evolution. OBJECTIVE To develop a guide for the clinical practice of adult female acne. METHODS A team of five experts with extensive experience in acne conducted a literature review of the main scientific evidence and met to discuss the best practices and personal experiences to develop a guide containing recommendations for the clinical practice of adult female acne. RESULTS The group of specialists reached consensus on the main guidelines for clinical practice, providing detailed recommendations on clinical picture, etiopathogenesis, laboratory investigation and treatment of adult female acne. CONCLUSION Different from teenage acne, adult female acne presents some characteristics and multiple etiopathogenic factors that make its management more complex. This guide provides recommendations for best clinical practices and therapeutic decisions. However, the authors consider that additional studies are needed in order to provide more evidence for adult female acne to be better understood.
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Affiliation(s)
- Edileia Bagatin
- Department of Dermatology, Escola Paulista de Medicina,
Universidade Federal de São Paulo, São Paulo (SP), Brazil
- Program of Post-Graduation in Translational Medicine, Escola
Paulista de Medicina, Universidade Federal de São Paulo, São Paulo
(SP), Brazil
| | - Thais Helena Proença de Freitas
- Dermatology Service, Hospital da Santa Casa de São Paulo,
Brazil
- Dermatology Clinic, Departamento de Clínica Médica,
Santa Casa de São Paulo, São Paulo (SP), Brazil
| | - Maria Cecilia Rivitti Machado
- Department of Dermatology, Hospital das Clínicas, Faculdade
de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
- Discipline of Dermatology, Faculdade de Medicina, Universidade
Metropolitana de Santos, Santos (SP), Brazil
| | - Beatriz Medeiros Ribeiro
- Dermatology Service, Hospital Regional da Asa Norte, Secretaria de
Saúde do Distrito Federal, Brasília (DF), Brazil
| | | | - Marco Alexandre Dias da Rocha
- Service of Cosmiatry, Department of Dermatology, Escola Paulista de
Medicina, Universidade Federal de São Paulo, São Paulo (SP),
Brazil
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Gualtieri B, Panduri S, Chiricozzi A, Romanelli M. Improvement of severe facial seborrheic dermatitis following low-dose isotretinoin therapy. GIORN ITAL DERMAT V 2018; 155:685-686. [PMID: 30249087 DOI: 10.23736/s0392-0488.18.06029-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bruno Gualtieri
- Department of Dermatology, "Santi Giovanni e Paolo" Hospital, Venice, Italy -
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Abstract
Seborrheic dermatitis (SD) is a chronic, recurring inflammatory skin disorder that manifests as erythematous macules or plaques with varying levels of scaling associated with pruritus. The condition typically occurs as an inflammatory response to Malassezia species and tends to occur on seborrheic areas, such as the scalp, face, chest, back, axilla, and groin areas. SD treatment focuses on clearing signs of the disease; ameliorating associated symptoms, such as pruritus; and maintaining remission with long-term therapy. Since the primary underlying pathogenic mechanisms comprise Malassezia proliferation and inflammation, the most commonly used treatment is topical antifungal and anti-inflammatory agents. Other broadly used therapies include lithium gluconate/succinate, coal tar, salicylic acid, selenium sulfide, sodium sulfacetamide, glycerin, benzoyl peroxide, aloe vera, mud treatment, phototherapy, among others. Alternative therapies have also been reported, such as tea tree oil, Quassia amara, and Solanum chrysotrichum. Systemic therapy is reserved only for widespread lesions or in cases that are refractory to topical treatment. Thus, in this comprehensive review, we summarize the current knowledge on SD treatment and attempt to provide appropriate directions for future cases that dermatologists may face.
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Affiliation(s)
- Luis J Borda
- a Department of Dermatology & Cutaneous Surgery , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Marina Perper
- a Department of Dermatology & Cutaneous Surgery , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Jonette E Keri
- a Department of Dermatology & Cutaneous Surgery , University of Miami Miller School of Medicine , Miami , FL , USA.,b Veterans Affairs Miami Health Care System , Miami , FL , USA
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Forbat E, Ali FR, Al-Niaimi F. Dermatological indications for the use of isotretinoin beyond acne. J DERMATOL TREAT 2018; 29:698-705. [PMID: 29480033 DOI: 10.1080/09546634.2018.1445194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
While the use of isotretinoin has revolutionized the treatment of acne vulgaris, isotretinoin is increasingly recognized as a useful therapeutic option for many other cutaneous conditions. We review the evidence underlying the use of isotretinoin for a variety of dermatological indications including hidradenitis suppurativa, sebaceous gland pathology, rosacea, scarring alopecia, cosmetic dermatology, and non-melanoma skin cancer prophylaxis amongst other uses, and thus consider alternative uses within dermatology practice. The studies found benefit of isotretinoin, however most trials lacked statistical power and in many cases the use was limited to case series. Isotretinoin, if used within the correct cohort with appropriate pretreatment counseling regarding side-effects, is a well-tolerated medication with potential as either an adjunctive treatment or a second-line agent in those recalcitrant cases unresponsive to first-line therapy.
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Affiliation(s)
- Emily Forbat
- a Chelsea and Westminster Hospital , London , UK
| | - Faisal R Ali
- b Dermatological Surgery & Laser Unit , St John's Institute of Dermatology, Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust , London , UK
| | - Firas Al-Niaimi
- b Dermatological Surgery & Laser Unit , St John's Institute of Dermatology, Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust , London , UK
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Kamamoto CSL, Nishikaku AS, Gompertz OF, Melo AS, Hassun KM, Bagatin E. Cutaneous fungal microbiome: Malassezia yeasts in seborrheic dermatitis scalp in a randomized, comparative and therapeutic trial. DERMATO-ENDOCRINOLOGY 2017; 9:e1361573. [PMID: 29484095 PMCID: PMC5821162 DOI: 10.1080/19381980.2017.1361573] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 07/26/2017] [Indexed: 01/26/2023]
Abstract
Malassezia spp in skin microbiome scalp has been implicated in seborrheic dermatitis pathogenesis. Thus, treatment based in antifungal combined to topical keratolitic agents have been indicated as well as oral isotretinoin as it reduces the sebum production, glandular's size and possesses anti-inflammatory properties. This randomized, comparative and therapeutic trial aimed toper form the genotypic identification of Malassezia species before and after low-dose oral isotretinoin or topical antifungal treatments for moderate to severe seborrhea and/or seborrheic dermatitis on scalp. Scales and sebum of the scalp were seeded in the middle of modified Dixon and incubated at 32°C. For genotypic identification polymerase chain reaction primers for the ITS and D1/D2 ribossomal DNA were used and followed by samples sequencing. The procedure was conducted before and after therapeutic and randomized intervention for moderate to severe seborrhea/seborrheic dermatitis on the scalp, including oral isotretinoin, 10 mg, every other day and anti-seborrheic shampoo (piroctone olamine), over six months. The M. globosa and M. restricta were the most frequent species isolated on the scalp before and after both treatments. Other non-Malassezia species were also identified. The Malassezia spp. were maintained in the scalp after both treatments that were equally effective for the control of seborrhea/seborrheic dermatitis clinical signs.
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Affiliation(s)
- C S L Kamamoto
- Department of Dermatology, Federal University of Sao Paulo (UNIFESP), São Paulo, SP, Brazil
| | - A S Nishikaku
- Department of Medicine, Special Mycology Laboratory, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - O F Gompertz
- Department of Microbiology, Immunology and Parasitology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - A S Melo
- Department of Medicine, Special Mycology Laboratory, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - K M Hassun
- Department of Dermatology, Federal University of Sao Paulo (UNIFESP), São Paulo, SP, Brazil
| | - E Bagatin
- Department of Dermatology, Federal University of Sao Paulo (UNIFESP), São Paulo, SP, Brazil
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