SELECTED ARTICLES FROM THE RECENT LITERATURE 2006

10/13/06

Side effects of isotretinoin

Summary
Background - Isotretinoin (Isot) is a potent agent used in the oral treatment for cystic acne, comedonal acne, and some other diseases. However, there are continuing concerns about the adverse effects of Isot (marketed as Accutane).

Findings - Scheinfeld and Bangalore of St. Luke's-Roosevelt Hospital in New York, NY reported a case of marked facial swelling during Isot treatment of a patient with acne without facial involvement. The swelling remitted promptly after cessation of Isot therapy. The authors commented that the most common side effects of Isot mucocutaneous/ocular (cheilitis, ocular sicca, xenosis) often requiring moisturization of the skin and eyes. The most serious adverse effect pf Isot is the induction of birth defects during Isot treatment of pregnant women. Thus, women in the child-bearing age should be on two forms of birth control and should give informed consent in advance if Isot treatment is used.

Reference
J Drugs Dermatol 2006;5:467-8

Editor's Comments
I have been given the impression that Isot treatment can be very effective in a small subset of severe acne patients unresponsive to other therapies. However, the potential for side effects, particularly teratogenic effects in pregnant women, indicate that Isot therapy should probably be given only by those with considerable experience with this agent.

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