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Besekar SM, Jogdand SD, Naqvi WM. A Systematic Review of Case Reports of a Rare Dermatological Condition: Elastosis Perforans Serpiginosa. Cureus 2023; 15:e40296. [PMID: 37448439 PMCID: PMC10337497 DOI: 10.7759/cureus.40296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
A systematic review was carried out on a rare dermatological condition affecting papillary dermal tissue fibers of the skin known as elastosis perforans serpiginosa (EPS). The aim of this review was to highlight this skin disease, its association with other medical conditions, and its management. The search was conducted by using the keywords "elastosis perforans serpiginosa" and "case reports" in the databases. A total of 10 case reports were analyzed and presented by the parameters like age, gender, chief complaints, and medical history. The most common causes of EPS were drug-induced and occurred along with the Wilson disease. The study concluded that as EPS is an uncommon disease with few instances, there is a need for further research to analyze randomized controlled trials that have been conducted in relation to the condition.
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Affiliation(s)
- Smruti M Besekar
- Pharmacology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Research, Humen Edutech, Nagpur, IND
| | - Sangita D Jogdand
- Pharmacology and Therapeutics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Oren-Shabtai M, Snast I, Noyman Y, Lapidoth M, Sherman S, Mimouni D, Hodak E, Levi A. Topical and systemic retinoids for the treatment of cutaneous viral warts: A systematic review and meta-analysis. Dermatol Ther 2020; 34:e14637. [PMID: 33278051 DOI: 10.1111/dth.14637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
Cutaneous viral warts (CVW), caused by human papillomavirus, often have a self-limited course. However, some patients experience a recalcitrant disease despite treatment. Retinoids are considered the mainstay of therapy in many dermatologic diseases. Data on their use for viral warts are limited. To systematically review the published evidence on the efficacy and safety of retinoids for the treatment of CVW. A systematic review and meta-analysis of topical or systemic retinoid treatment for CVW was performed in accordance with the PRISMA statement. The primary outcome was clinical response; secondary outcomes were recurrence rate and adverse events. Fourteen publications including 399 patients treated exclusively with retinoids (65% topical, 35% systemic) were evaluated. The complete response rate was 64% (95% CI, 46-78%; I2 =80%) for topical treatment and 61% (95% CI, 44-76%; I2 =69%) for systemic treatment. The most common side effects were irritant contact dermatitis and cheilitis, respectively. Relapse rates were 6% and 17%, respectively. The reviewed studies were considerably heterogenous and most lacked a control group. Both topical and systemic retinoids are effective and safe as monotherapy for CVW. Further studies are required to determine their exact role in this setting.
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Affiliation(s)
- Meital Oren-Shabtai
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Igor Snast
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehonatan Noyman
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Lapidoth
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shany Sherman
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Mimouni
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assi Levi
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Oren-Shabtai M, Snast I, Lapidoth M, Sherman S, Noyman Y, Mimouni D, Hodak E, Levi A. Topical and Systemic Retinoids for the Treatment of Genital Warts: A Systematic Review and Meta-Analysis. Dermatology 2020; 237:389-395. [PMID: 33279886 DOI: 10.1159/000511398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/26/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Genital warts, caused by the human papillomavirus, are a common sexually transmitted disease. The warts can regress spontaneously or exhibit a persistent clinical course. Various therapeutic modalities are available, yet none is curative, and there may be recurrences. Retinoids are considered the mainstay of therapy in many dermatologic diseases. Data on their use for genital warts are limited. OBJECTIVE To systematically review the published evidence on the efficacy and safety of retinoids for the treatment of genital warts. METHODS A systematic review and meta-analysis of all publications evaluating topical or systemic retinoids for the treatment of genital warts was performed. The primary outcome was complete response (CR); the secondary outcomes were recurrence rate and adverse events. RESULTS Six publications were evaluated, three randomized controlled trials and three prospective cohort studies, including a total of 141 patients with genital warts treated exclusively with retinoids (90% with isotretinoin). CR rates were 100% for systemic etretinate (3 out of 3 patients, 95% CI 28-81%) and 56% for isotretinoin (95% CI 28-81%; I2 = 84%). Topical etretinate did not induce CR. The most common side effect of topical agents was irritant contact dermatitis (36%) and that of systemic agents mucocutaneous disorders (80%). The relapse rate was 12% for oral isotretinoin and was unavailable for the other modalities. CONCLUSIONS Current data suggest that unlike topical retinoids, systemic retinoids are an effective and safe treatment for genital warts. Further studies are required to determine their specific role and the most effective regimen for each derivative.
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Affiliation(s)
- Meital Oren-Shabtai
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Igor Snast
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Lapidoth
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shany Sherman
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehonatan Noyman
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Mimouni
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assi Levi
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Chu S, Michelle L, Ekelem C, Sung CT, Rojek N, Mesinkovska NA. Oral isotretinoin for the treatment of dermatologic conditions other than acne: a systematic review and discussion of future directions. Arch Dermatol Res 2020; 313:391-430. [PMID: 33151346 DOI: 10.1007/s00403-020-02152-4] [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: 06/13/2020] [Revised: 09/29/2020] [Accepted: 10/09/2020] [Indexed: 11/28/2022]
Abstract
While isotretinoin has been the gold-standard of therapy for severe acne since its approval in 1982, its anti-inflammatory properties makes it a potentially applicable and versatile therapy for a wide variety of dermatologic conditions yet to be explored. This systematic review comprehensively recounts the success of oral isotretinoin in non-acne cutaneous diseases and provide insight into future directions of isotretinoin utility. A systematic literature review was performed using PubMed. Search terms included "isotretinoin" OR "accutane" AND "skin" OR "dermatology" OR "hair" OR "nails" OR "rosacea" OR "psoriasis" OR "pityriasis rubra pilaris" OR "condyloma acuminata" OR "granuloma annulare" OR "darier's disease" OR "non-melanoma skin cancer" OR "frontal fibrosing alopecia" OR "cutaneous lupus erythematosus" OR "hidradenitis suppurativa" OR "photodamaged skin" OR "skin aging" OR "wart" OR "flat warts" OR "plane warts" OR "lichen planus" OR "dissecting cellulitis" OR "folliculitis decalvans" OR "sebaceous hyperplasia" OR "cutaneous t-cell lymphoma" OR "mycosis fungoides." A total of 169 studies discuss the use of oral isotretinoin for 16 non-acne dermatologic conditions, the most common being non-melanoma skin cancers (0.2-8.2 mg/kg/day), cutaneous T-cell lymphomas (0.5-2 mg/kg/day), and rosacea (0.22-1 mg/kg/day). Inflammatory conditions such as rosacea, granuloma annulare, and hidradenitis suppurativa benefit from lower oral isotretinoin dosage of 0.3-1 mg/kg/day, whereas, hyperkeratotic diseases such as psoriasis and pityriasis rubra pilaris, consistently respond better to higher dosages of up to 2-4 mg/kg/day for lesion clearance. Recurrence of disease following discontinuation of isotretinoin have been reported for rosacea, psoriasis, granuloma annulare, Darier's disease, dissecting cellulitis, and non-melanoma skin cancers. Disease exacerbation was reported in some patients with hidradenitis suppurativa. Off-label isotretinoin is an effective treatment choice for dermatological conditions beyond acne. Further prospective, randomized human trials are needed to clarify when and how to prescribe off-label isotretinoin for maximum efficacy and safety.
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Affiliation(s)
- Sherman Chu
- College of Osteopathic Medicine of the Pacific, Northwest, Western University of Health Sciences, 200 Mullins Dr., Lebanon, OR, 97355, USA. .,Department of Dermatology, University of California, Irvine, Irvine, CA, 92697, USA.
| | - Lauren Michelle
- Department of Dermatology, University of California, Irvine, Irvine, CA, 92697, USA
| | - Chloe Ekelem
- Department of Dermatology, University of California, Irvine, Irvine, CA, 92697, USA
| | - Calvin T Sung
- Department of Dermatology, University of California, Irvine, Irvine, CA, 92697, USA
| | - Nathan Rojek
- Department of Dermatology, University of California, Irvine, Irvine, CA, 92697, USA
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The effect of high-fat diet and 13-cis retinoic acid application on lipid profile, glycemic response and oxidative stress in female Lewis rats. PLoS One 2020; 15:e0238600. [PMID: 32947606 PMCID: PMC7500970 DOI: 10.1371/journal.pone.0238600] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/19/2020] [Indexed: 01/24/2023] Open
Abstract
Vitamin A and its metabolites are key regulators of the development of adipose tissue and associated metabolic complications. The aim of this study was to determine the effect of high fat diet and 13-cis retinoic acid (13 cRA) application on metabolic parameters, adipogenic and inflammatory indicators in female Lewis rats. Female rats of Lewis strain were fed standard laboratory diet (STD) and high fat diet (HFD, 45% of saturated fatty acids) during 30 days. The groups were divided into additional 3 groups (6 rats each): two experimental groups that received 13 cRA orally on a daily basis during 30 days (7.5 mg/kg and 15 mg/kg, respectively) and the control group that was given sunflower oil. Animals were sacrificed after 60 days. Feeding of Lewis rats with chronic HFD diet with 13 cRA supplementation increased weight gain, adiposity index, dyslipidaemia, hyperleptinaemia, insulin resistance, VLDL concentrations, oxidative stress and atherogenic indices. Administration of 13 cRA in Lewis rats fed STD did not change the weight of the animals, but it slightly increased the atherogenic parameters. 13 cRA and HFD affect metabolic parameters, glucose and lipid metabolism in Lewis rats and its administration has a completely different effect on metabolism in rats fed STD, highlighting the complex role of vitamin A supplementation in obesity. Other factors, such as genetics, age, sex, adipose tissue distribution, also must be taken into consideration.
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Nofal A, Khedr A, Fathy M. Combined oral isotretinoin and Candida antigen versus either agent alone in the treatment of plane warts. J DERMATOL TREAT 2020; 33:342-347. [DOI: 10.1080/09546634.2020.1754325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Ahmad Nofal
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amany Khedr
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Marwa Fathy
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Öktem A, Hayran Y, Arı E, Yalçın B. Minimize the regular laboratory monitoring during the systemic isotretinoin treatment: data of 704 patients with acne vulgaris. J DERMATOL TREAT 2019; 30:813-817. [DOI: 10.1080/09546634.2019.1591578] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ayşe Öktem
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Yıldız Hayran
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Esra Arı
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Başak Yalçın
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Plane warts on the back of the hand successfully treated with oral isotretinoin. Postepy Dermatol Alergol 2018; 35:227-229. [PMID: 29760629 PMCID: PMC5949540 DOI: 10.5114/pdia.2017.70259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 08/24/2017] [Indexed: 11/17/2022] Open
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10
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Falola RA, DeFazio MV, Anghel EL, Mitnick CDB, Attinger CE, Evans KK. What Heals Hidradenitis Suppurativa. Plast Reconstr Surg 2016; 138:219S-229S. [DOI: 10.1097/prs.0000000000002671] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bauer LB, Ornelas JN, Elston DM, Alikhan A. Isotretinoin: controversies, facts, and recommendations. Expert Rev Clin Pharmacol 2016; 9:1435-1442. [DOI: 10.1080/17512433.2016.1213629] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | | | - Dirk M. Elston
- Department of Dermatology, Medical University of South Carolina, Charleston, SC, USA
| | - Ali Alikhan
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Muthu SK, Narang T, Saikia UN, Kanwar AJ, Parsad D, Dogra S. Low-dose oral isotretinoin therapy in lichen planus pigmentosus: an open-label non-randomized prospective pilot study. Int J Dermatol 2016; 55:1048-54. [PMID: 27062273 DOI: 10.1111/ijd.13293] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 11/12/2015] [Accepted: 12/18/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND Lichen planus pigmentosus (LPP) is a cosmetically distressing pigmentary disorder often posing a therapeutic challenge. Isotretinoin has been shown to be effective in oral and cutaneous LP, but its role in LPP is yet unknown. OBJECTIVE To evaluate the efficacy and safety of isotretinoin in the management of LPP. METHODS In this prospective study, 32 clinically and histologically proven patients with LPP were recruited. Subjects were treated with fixed low-dose (20 mg/day) oral isotretinoin once daily for 6 months along with topical sunscreens. Response was graded as mild (<25%), moderate (26-50%), and good (>50%) improvement based on decrease in intensity and progression of hyperpigmentation. RESULTS Twenty-seven patients (17 females and 10 males), aged 20-62 years, completed the study. Twenty-three (85.2%) patients had active disease and pruritus at presentation. Treatment outcome was moderate improvement in 15 patients (55.7%) followed by good in seven (21.8%) and mild in two (6.2%). Pruritus subsided at the earliest at 9-14 days, and disease stabilized by 4-6 weeks in treatment-responsive patients. Patients with a shorter duration (≤5 years) of disease and limited body area involvement had a better outcome. CONCLUSIONS Low-dose isotretinoin seems to be a promising treatment modality in stabilizing and decreasing the pigmentation in LPP particularly in early and limited disease.
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Affiliation(s)
- Sendhil Kumaran Muthu
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma N Saikia
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amrinder Jit Kanwar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Gahalaut P, Soodan PS, Mishra N, Rastogi MK, Soodan HS, Chauhan S. Clinical efficacy of psoralen + sunlight vs. combination of isotretinoin and psoralen + sunlight for the treatment of chronic plaque-type psoriasis vulgaris: a randomized hospital-based study. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2014; 30:294-301. [PMID: 24828298 DOI: 10.1111/phpp.12125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Isotretinoin has been used in combination with oral psoralen + UVA (PUVA) and narrowband UVB (NBUVB) for treating psoriasis, especially in women of child-bearing age. The efficacy of oral psoralen + sun exposure (PUVAsol) is comparable to that of PUVA. This study was planned to compare the efficacy of oral PUVAsol with that of the combination of oral isotretinoin and PUVAsol in patients with chronic plaque psoriasis. METHODS Forty patients with psoriasis vulgaris were randomized to two groups. Group A (control group) received PUVAsol only. Group B (intervention group) received PUVAsol + isotretinoin (0.5 mg/kg/day). Psoriasis Area Severity Index (PASI) score was recorded at baseline and weeks 4, 8 and 12. Dermatology Life Quality Index was assessed at baseline and 12 weeks. The end point of the study was PASI 75 or 12 weeks, whichever came earlier. RESULTS Thirty-five patients completed the study. There were statistically significant differences between the two study groups for the number of patients achieving the endpoint of PASI 75, PASI scores at the end of 12 weeks, mean duration to achieve PASI 75, number of PUVAsol sessions needed to achieve PASI75 and mean cumulative dosage of 8-methoxypsoralen needed to achieve PASI 75. CONCLUSION The combination of isotretinoin with PUVAsol is more effective compared with PUVAsol alone for treating chronic plaque psoriasis.
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Affiliation(s)
- Pratik Gahalaut
- Department of Dermatology, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, India
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Öztürk S, Öztürk T, Ucak H, Erden I, Demir B, Kayalı A, Cicek D. Evaluation of ovarian reserve and function in female patients treated with oral isotretinoin for severe acne: an exploratory study. Cutan Ocul Toxicol 2014; 34:21-4. [DOI: 10.3109/15569527.2014.888079] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bagatin E. Oral isotretinoin: the most promising dermatological off-label uses. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.10.58] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Bagatin E, Guadanhim LRS, Enokihara MMSS, Sanudo A, Talarico S, Miot HA, Gibson L. Low-dose oral isotretinoin versus topical retinoic acid for photoaging: a randomized, comparative study. Int J Dermatol 2013; 53:114-22. [DOI: 10.1111/ijd.12191] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Edileia Bagatin
- Department of Dermatology; Universidade Federal de São Paulo (UNIFESP); SN Botucatu SP Brazil
| | - Lilia R. S. Guadanhim
- Department of Dermatology; Universidade Federal de São Paulo (UNIFESP); SN Botucatu SP Brazil
| | | | - Adriana Sanudo
- Department of Dermatology; Universidade Federal de São Paulo (UNIFESP); SN Botucatu SP Brazil
| | - Sérgio Talarico
- Department of Dermatology; Universidade Federal de São Paulo (UNIFESP); SN Botucatu SP Brazil
| | - Helio A. Miot
- Department of Dermatology; Universidade Federal de São Paulo (UNIFESP); SN Botucatu SP Brazil
| | - Lawrence Gibson
- Department of Dermatology; Universidade Federal de São Paulo (UNIFESP); SN Botucatu SP Brazil
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Abali R, Yuksel MA, Aktas C, Celik C, Guzel S, Erfan G, Sahin O. Decreased ovarian reserve in female Sprague–Dawley rats induced by isotretinoin (retinoic acid) exposure. Reprod Biomed Online 2013; 27:184-91. [DOI: 10.1016/j.rbmo.2013.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 03/22/2013] [Accepted: 04/09/2013] [Indexed: 11/25/2022]
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Al-Hamamy HR, Salman HA, Abdulsattar NA. Treatment of Plane Warts with a Low-Dose Oral Isotretinoin. ISRN DERMATOLOGY 2012; 2012:163929. [PMID: 23304543 PMCID: PMC3530790 DOI: 10.5402/2012/163929] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 11/21/2012] [Indexed: 11/23/2022]
Abstract
Objective. To assess the efficacy of a low-dose oral isotretinoin in the treatment of plane warts. Patients and Methods. Thirty-one patients with recalcitrant facial plane warts were enrolled. A cumulative dose of 30 mg/kg for two months of treatment was calculated; this was equal to a mean of 0.5 mg/kg/day. Each patient was seen every two weeks during the treatment period. Response to treatment was either complete or no response. Patients with complete response were followed up monthly for four months to record the relapse rate. Results. Twenty-six patients completed the study; their ages range from 5 to 35 with a mean ± SD 15.28 ± 8.51 years. Fifteen (57.69%) patients were females and eleven (42.30%) were males. Nineteen (73.07%) patients showed complete response and seven (26.92%) patients showed no response at the end of two months of therapy. The difference was statistically significant; P value <0.0001. Fifteen (78.94%) out of nineteen patients, who had complete response, were still free from warts at the end of four-month followup. Conclusion. Oral isotretinoin is effective in the treatment of recalcitrant facial plane warts.
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Affiliation(s)
- Hayder R. Al-Hamamy
- Department of Dermatology and Venereology, College of Medicine, University of Baghdad, Medical Collection Office, P.O. Box 61211, Baghdad 12114, Iraq
| | - Husam Ali Salman
- Department of Dermatology and Venereology, College of Medicine, University of Baghdad, Medical Collection Office, P.O. Box 61211, Baghdad 12114, Iraq
| | - Nawar A. Abdulsattar
- Department of Dermatology and Venereology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
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Neuritis óptica probablemente inducida por isotretinoína. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:843-4. [DOI: 10.1016/j.ad.2011.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 10/25/2011] [Accepted: 10/30/2011] [Indexed: 11/22/2022] Open
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Optic Neuritis Probably Induced by Isotretinoin. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2011.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Systemic isotretinoin with topical tretinoin cream in the treatment of multiple warty dyskeratomas. DERMATOL SIN 2011. [DOI: 10.1016/j.dsi.2011.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Rademaker M. Adverse effects of isotretinoin: A retrospective review of 1743 patients started on isotretinoin. Australas J Dermatol 2010; 51:248-53. [DOI: 10.1111/j.1440-0960.2010.00657.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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AKSAKAL ABURHAN, ADIŞEN ESRA. Hidradenitis Suppurativa: Importance of Early Treatment; Efficient Treatment with Electrosurgery. Dermatol Surg 2007; 34:228-31. [DOI: 10.1111/j.1524-4725.2007.34042.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Antiandrogenic effect of isotretinoin: is the retina involved in mechanism of action? Med Hypotheses 2007; 69:1281-3. [PMID: 17512125 DOI: 10.1016/j.mehy.2007.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Accepted: 03/25/2007] [Indexed: 11/28/2022]
Abstract
Isotretinoin (13-cis retinoic acid) has been the most effective available drug for severe acne vulgaris. Isotretinoin inhibits proliferation of sebocytes and can also reduce lipid synthesis, but its antiandrogenic effect remains uncertain. Decreased dark adaptation is one of the commonest ophthalmological adverse events of isotretinoin, which could be transient and permanent as well. Isotretinoin causes loss of night vision by slowing rhodopsin regeneration and chromophore recycling by the inhibition of 11-cis retinol dehydrogenase. The primary photoreceptors of the circadian pacemaker are the melanopsin containing intrinsically photosensitive retinal ganglion cells (ipRGC). Since the photochemistry of melanopsin is very similar to other opsin photopigments, and it is known that melanopsin uses the same retinaldehyde chromophore, it is hypothesized here that isotretinoin may exert inhibitory effect on chromophore regeneration in ipRGCs similar to what is seen in rod and cone cells, thus enabling to alter circadian and circannual rhythms. Mechanism of action of isotretinoin may involve neuroendocrine-reproductive axis in its antiandrogenic effect, and melatonin may mediate this action.
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Abstract
Xeroderma pigmentosum (XP) is a rare autosomal recessive genodermatosis. Skin abnormalities result from an inability to repair UV-damaged DNA. Clinically, XP presents with early onset cutaneous changes (severe photosensitivity, actinic keratoses, and telangiectasias) and an increase of developing cutaneous malignancies beginning in early childhood, but lentigo maligna and melanomas are relatively rare. Here we report on homozygote twins in whom there was no positive family history. They showed subnormal physical growth. On ophthalmological examination, both had photophobia and decreased visual acuity. Since birth, several excisions had been performed for skin neoplasms. In one of them a pigmented patch developed over the frontal area which proved to be lentigo maligna and she was referred to a dermato-oncology center. They have been given isotretinoin and physical sunscreen since then. The follow-up period was extended to 2 years and no serious complications occurred from the above treatment. This is an interesting report about XP in twins with the presentation of the rare neoplasm lentigo maligna.
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Affiliation(s)
- Gita Faghihi
- Department of Dermatology, Shahid Beheshti Hospital, Isfahan University School of Medicine, Isfahan, Iran.
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