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Isotretinoin

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1. Oral isotretinoin for acne. (PubMed)

Oral isotretinoin for acne. Acne vulgaris, a chronic inflammatory disease of the pilosebaceous unit associated with socialisation and mental health problems, may affect more than 80% of teenagers. Isotretinoin is the only drug that targets all primary causal factors of acne; however, it may cause adverse effects.To assess efficacy and safety of oral isotretinoin for acne vulgaris.We searched the following databases up to July 2017: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE (...) , Embase, PsycINFO and LILACS. We updated this search in March 2018, but these results have not yet been incorporated in the review. We also searched five trial registries, checked the reference lists of retrieved studies for further references to relevant trials, and handsearched dermatology conference proceedings. A separate search for adverse effects of oral isotretinoin was undertaken in MEDLINE and Embase up to September 2013.Randomised clinical trials (RCTs) of oral isotretinoin in participants

2018 Cochrane

2. Evaluation of the efficacy and safety of oral isotretinoin versus topical isotretinoin in the treatment of plane warts: a randomized open trial. (PubMed)

Evaluation of the efficacy and safety of oral isotretinoin versus topical isotretinoin in the treatment of plane warts: a randomized open trial. Plane warts are a common therapeutic problem. Our aim was to assess the efficacy and safety of oral versus topical isotretinoin in the treatment of plane warts.Forty patients with multiple plane warts were randomized into two groups. Group A was treated with oral isotretinoin capsules in the dose of 0.5 mg/kg/d and Group B with topical isotretinoin (...) (38%) patients had complete remission and six (46%) had partial remission, whereas two patients had no remission. The difference was statistically significant between two groups; P < 0.0001. The most common side effect in Group A was cheilitis. In Group B, five patients had to be dropped because they developed severe erythema and scaling.Oral isotretinoin showed better and earlier response than topical isotretinoin. Oral isotretinoin should definitely be given a trial particularly in cases

2017 International Journal of Dermatology

3. Compliance with national guidelines on isotretinoin: where are we 2 years since the last audit? Results of the National Isotretinoin Re-Audit 2014. (PubMed)

Compliance with national guidelines on isotretinoin: where are we 2 years since the last audit? Results of the National Isotretinoin Re-Audit 2014. In 2010, the British Association of Dermatologists (BAD) published clinical guidelines for the safe introduction and continued use of isotretinoin in patients with acne in the UK. The BAD provides UK dermatologists with a facility for national audit, and it undertook an audit on compliance with these guidelines in 2012.To determine current clinical (...) practices relating to use of isotretinoin among dermatologists in the UK (including geographical variations) as measured against BAD standards, and to ascertain any improvement since the 2012 audit.The 2012 isotretinoin audit proforma was used, with additional questions on clinical setting, complaints and litigation. A web-based survey tool was used for data entry and submission, with email invitation to working, UK-based BAD members (n = 1226) in December 2013 and weekly reminders during the 8.5-week

2017 Clinical & Experimental Dermatology

4. Is less more with isotretinoin and acne?

Is less more with isotretinoin and acne? Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,000 family physicians, family medicine residents and medical students in Alberta. Established over fifty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research. www.acfp.ca March 14, 2016 Is less more (...) with isotretinoin and acne? Clinical Question: What is the efficacy and tolerability of low-dose compared to conventional dose isotretinoin in the treatment of acne? Bottom-line: Small randomized controlled trials (RCTs) and observational studies demonstrate low-dose (~20mg/day) isotretinoin improves acne similar to conventional dosing. Low-dose may reduce common side effects (chapped lips, dry skin, epistaxis) by 16-35% but may be associated with increased relapse rates, particularly with severe acne

2016 Tools for Practice

5. Compliance with Pregnancy Prevention Recommendations for Isotretinoin in Estonia in 2012–2016 (PubMed)

Compliance with Pregnancy Prevention Recommendations for Isotretinoin in Estonia in 2012–2016 Isotretinoin is an effective treatment for severe acne; no alternative treatment has an equal therapeutic effect. The teratogenic effects of isotretinoin can be avoided, and numerous recommendations and regulations are in force to minimize the risk of pregnancy during treatment.To describe isotretinoin prescription patterns for women aged 15-45 years, assess the concomitancy of isotretinoin (...) and contraceptive use, and determine the rate of potential isotretinoin-exposed pregnancies in Estonia.This retrospective, nationwide, population-based, cohort study derived data from national health insurance databases and included female patients aged 15-45 years in Estonia for whom one or more prescriptions for isotretinoin were dispensed between 2012 and 2016. The main outcome was the proportion of women who used systemic isotretinoin and had a concomitant record of (hormonal or intrauterine) contraception

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2018 Drugs - real world outcomes

6. Differences in isotretinoin start, interruption, and early termination across race and sex in the iPLEDGE era. (PubMed)

Differences in isotretinoin start, interruption, and early termination across race and sex in the iPLEDGE era. iPLEDGE is the mandatory regulatory program for isotretinoin in the United States, aimed to prevent isotretinoin-related teratogenicity. However, little is known about potential unintended impact of the program, including delay in isotretinoin initiation, course interruption, and premature termination, which may vary across sex and racial domains.To determine whether differences (...) in isotretinoin start, interruption, and completion exist across sex and racial domains and whether iPLEDGE regulations contribute to such differences.Retrospective review of isotretinoin courses of patients prescribed isotretinoin for acne at the Brigham & Women's Hospital and Massachusetts General Hospital from 2008-2016.418 patients were included in analysis after being tightly matched across age and gender. 43.5% of non-white patients ended their course early compared to 30.1% of white patients (p = 0.010

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2019 PLoS ONE

7. Relationship between acne vulgaris and insulin resistance markers and effect of isotretinoin on insulin resistance markers in patients with acne vulgaris: a systematic review and meta-analysis

Relationship between acne vulgaris and insulin resistance markers and effect of isotretinoin on insulin resistance markers in patients with acne vulgaris: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears

2019 PROSPERO

8. The effects of isotretinoin treatment on serum homocysteine, folate and vitamin B12 levels in patients with acne: a systematic review and meta-analysis

The effects of isotretinoin treatment on serum homocysteine, folate and vitamin B12 levels in patients with acne: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

9. Hepatotoxicity in the setting of isotretinoin use in the treatment of acne

Hepatotoxicity in the setting of isotretinoin use in the treatment of acne Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email

2019 PROSPERO

10. Reply to: "Could Isotretinoin flare Hidradentis suppurativa? A Case Series". (PubMed)

Reply to: "Could Isotretinoin flare Hidradentis suppurativa? A Case Series". We read with interest the manuscript recently published by Gallagher1 et al. concerning eight patients with severe acne who were treated with isotretinoin and developed hidradenitis suppurativa (HS). Conversely to the authors, we experienced flares in patients with HS treated with retinoids. We report three cases of patients with moderate-severe HS localized in their axillae and groins. This article is protected

2019 Clinical & Experimental Dermatology

11. Isotretinoin and Hidradenitis Suppurativa. (PubMed)

Isotretinoin and Hidradenitis Suppurativa. We read with great interest the article by Gallagher et al.1 , in which eight patients with severe acne vulgaris, who were treated with Isotretinoin, developed painful nodules in their axillae and groins consistent with Hidradenitis Suppurativa (HS). These observations prompted that systemic Isotretinoin may cause flares of HS, particularly in young, thin males. This article is protected by copyright. All rights reserved.This article is protected

2019 Clinical & Experimental Dermatology

12. Oral Isotretinoin in the Treatment of Postoperative Edema in Thick-Skinned Rhinoplasty: A Randomized Placebo-Controlled Clinical Trial. (PubMed)

Oral Isotretinoin in the Treatment of Postoperative Edema in Thick-Skinned Rhinoplasty: A Randomized Placebo-Controlled Clinical Trial. The thick-skinned nose is still one of the most challenging aspects of rhinoplasty. The possible effects of oral isotretinoin on cosmetic results of rhinoplasty in patients with thick nasal skin have been considered during recent years.In this double-blind placebo-controlled clinical trial, 48 cases were divided into two groups randomly. Oral isotretinoin (0.5 (...) -mg/kg) was started on the 31st day after surgery and given every other day for 1 month and after that daily for two additional months in the first group. The second group received a placebo in the same form, sequence and interval as the first group. The cosmetic results based on patient satisfaction and ranking by an expert surgeon were compared between the two groups at 3 months, 6 months and 1 year after surgery.Patient satisfaction and ranking by an expert surgeon in the isotretinoin group

2019 Aesthetic plastic surgery

13. Minimise the regular laboratory monitoring during the systemic isotretinoin treatment: data of 704 patients with acne vulgaris. (PubMed)

Minimise the regular laboratory monitoring during the systemic isotretinoin treatment: data of 704 patients with acne vulgaris. Backround: Despite extensive usage of systemic isotretinoin in patients with acne for many years, laboratory monitoring protocols for adverse effects depend on the centers and there is no standardized practice for frequency and type of laboratory testing. We aimed to decrease unnecessary monitoring and to standardize our general clinical practice of our department (...) as well as to provide patient comfort and cost saving.The medical charts of 704 acne patients treated with systemic isotretinoin were reviewed retrospectively. The National Cancer Institute common terminology criteria for adverse events v3.0 grading system was used in order to categorize the laboratory abnormalities of liver functions and lipid levels.All laboratory abnormalities were grade I. Abnormal liver function was seen in 7.2% of the patients (n = 51), maximum values were ALT: 87 IU/L, AST: 97

2019 Journal of Dermatological Treatment

14. Is there an association between isotretinoin therapy and adverse mood changes? A prospective study in a cohort of acne patients. (PubMed)

Is there an association between isotretinoin therapy and adverse mood changes? A prospective study in a cohort of acne patients. Treatment with isotretinoin has been associated with adverse mood changes. However, even though a number of studies support this association, others refute it, and a concrete causal link has yet to be proven. Acne itself is associated with depressive symptoms, thus making studies on the topic difficult to design and interpret.Using validate tools, we performed (...) a prospective study in order to assess the effects of treatment with isotretinoin on the mood of patients with acne vulgaris.Fifty-six patients were included with a mean age of 21 years. At baseline, questionnaire scores for all measured parameters were indicative of lower mood than published norms. During and after treatment, values of either stable or improving mood were displayed across all questionnaires. Three patients developed significantly deteriorating moods, two of whom also experienced severe

2019 Journal of Dermatological Treatment

15. Could Isotretinoin flare Hidradentis suppurativa? A Case Series. (PubMed)

Could Isotretinoin flare Hidradentis suppurativa? A Case Series. We report eight cases of patients with severe acne who were treated with Isotretinoin and developed painful nodules in their axillae and groin consistent with Hidradenitis Suppurativa (HS). The pathogenesis of HS is still not completely understood; recent research from a study in 2011 of biopsies from HS lesions showed a reduction or absence of sebaceous glands compared to normal skin in HS patients and the author suggested (...) this contributes to the pathogenesis of the disease. Interestingly the main effect of Isotretinoin is to decrease the size and action of sebaceous glands; so hypothetically, as Isotretinoin acts by reducing the sebaceous glands further it could potentially aggravate the condition. Our experience has instilled caution in our prescribing of Isotretinoin; patients are questioned about symptoms of HS prior to and during treatment, particularly patients with acne conglobata. This article is protected by copyright

2019 Clinical & Experimental Dermatology

16. A randomized, open, controlled trial of tretinoin 0.05% cream vs. low-dose oral isotretinoin for the treatment of field cancerization. (PubMed)

A randomized, open, controlled trial of tretinoin 0.05% cream vs. low-dose oral isotretinoin for the treatment of field cancerization. Sun exposure may lead to actinic keratoses (AKs), field cancerization, and skin cancer. Effective treatment of AKs and field cancerization is important. Oral and topical retinoids can be used for this purpose. To compare clinical, histological, and immunohistochemical effects of oral and topical retinoid for AKs and field cancerization on face and upper limbs (...) of immunocompetent patients, as well as the impact on quality of life, safety, and tolerability.This study compared 10 mg/day oral isotretinoin (ISO) to 0.05% tretinoin cream (TRE) every other night, associated with sunscreen (SPF 60). Patients of both genders, aged 50-75 years, underwent cryotherapy with liquid nitrogen for AKs at baseline and after 120 days when they were randomized into two groups, TRE (n = 31) and ISO (n = 30), for 6 months. Outcome measures were: number of AKs, histological (thickness

2019 International Journal of Dermatology

17. Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis. (PubMed)

Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis. This study aimed to investigate the association between the use of isotretinoin and the risk of depression in patients with acne.This was a meta-analysis in which the standardised mean difference (SMD) and the relative risk (RR) were used for data synthesis employing the random-effects model.Studies were identified via electronic searches of PubMed, Embase and the Cochrane Library from (...) inception up to 28 December 2017.Patients with acne.Studies comparing isotretinoin with other interventions in patients with acne were included.Twenty studies were selected. The analysis of 17 studies showed a significant association of the use of isotretinoin with improved symptoms compared with the baseline before treatment (SMD = -0.33, 95% CI -0.51 to -0.15, p<0.05; I2=76.6%, p<0.05)). Four studies were related to the analysis of the risk of depression. The pooled data indicated no association

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2019 BMJ open

18. The Effects of Isotretinoin on Affective and Cognitive Functions are Disparate in Adolescent Acne Vulgaris Patients. (PubMed)

The Effects of Isotretinoin on Affective and Cognitive Functions are Disparate in Adolescent Acne Vulgaris Patients. The vulnerable brain regions to isotretinoin are represented as hippocampus and prefrontal cortex, involved in mood regulation as well as coordination of cognitive functions. Adolescence is a critical period with dynamic alterations in neurocognition. Isotretinoin brought concerns about its possible effects on executive functions, attention and memory.Evaluate the impacts (...) of isotretinoin on neurocognitive functions in adolescents with acne vulgaris and determine the emergence of psychiatric side effects.Fifty-five adolescent acne vulgaris patients were assigned to either isotretinoin (n = 38) or systemic antibiotic (n = 17) groups. The neuropsychological test battery and psychometric tests were performed before treatment and during treatment with 3-months intervals.Stroop-TBAG form, verbal-auditory digit span, controlled oral word association test and trail making test results

2019 Journal of Dermatological Treatment

19. The combined effect of tranilast 8% liposomal gel on the final cosmesis of acne scarring in patients concomitantly treated by isotretinoin: Prospective double blind split-face study. (PubMed)

The combined effect of tranilast 8% liposomal gel on the final cosmesis of acne scarring in patients concomitantly treated by isotretinoin: Prospective double blind split-face study. Tranilast, N-(3,4-dimethoxycinnaoyl) anthranilic acid has never been investigated for the prevention and treatment of acne scars.To evaluate the efficacy and safety of tranilast 8% gel in improving the final appearance of patients with acne scarring concomitantly treated by isotretinoin.One-half of the faces of 40 (...) lower (better outcome) for the tranilast-treated side than the placebo-treated areas in patients concomitantly treated with isotretinoin (P < 0.001). All the isotretinoin-treated patients reported greater satisfaction and better general improvement in the skin's appearance and texture, as well as greater improvement of pigmentary and redness alteration on the tranilast 8% gel-treated side compared to the control side.Combined topical application of tranilast 8% gel twice daily with oral isotretinoin

2019 Clinical & Experimental Dermatology

20. The Clinical Utility of Laboratory Monitoring During Isotretinoin Therapy for Acne and Changes to Monitoring Practices Over Time. (PubMed)

The Clinical Utility of Laboratory Monitoring During Isotretinoin Therapy for Acne and Changes to Monitoring Practices Over Time. Due to concerns about hypertriglyceridemia, liver enzyme abnormalities, and leukopenia during isotretinoin therapy for acne, patients are often followed closely with routine laboratory monitoring, although the value of this practice has been questioned.We conducted a cohort study of patients receiving isotretinoin for acne between January 1, 2008 and June 30, 2017 (...) using the OptumInsights Electronic Health Record Database to evaluate the frequency of laboratory abnormalities. Poisson regression was used to evaluate for changes to the frequency of routine laboratory monitoring over time.Among 1,863 patients treated with isotretinoin, grade 3 or greater triglyceride and liver function testing abnormalities were noted in fewer than 1% and 0.5% of patients screened, respectively. No grade 3 or greater cholesterol or complete blood count abnormalities were observed

2019 Journal of American Academy of Dermatology

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