Evaluation of Side Effects of Isotretinoin in 150 Patients With Acne Vulgaris

Abstract

Background and Design: Isotretinoin is commonly used and effective treatment for acne. It has various side effects affecting lots of systems in the body. Nowadays, new cases are being reported regarding these side effects, and the number of studies related with long-term results is insufficient. In this study, the results and side effects of isotretinoin treatment were evaluated. Material and Method: One hundred and fifty patients with the diagnosis of moderate to severe acne were included in the study. The patients and their relatives were informed about the possible side effects. Isotretinoin treatment at a dose of 0.5-0.75 mg/kg/day was initiated and the cumulative dose of 120-150 mg/kg was achieved. The patients were scheduled for monthly follow-up visits. Results: Ninety-seven (64.6%) patients were women, 53 (35.4%) were men. All were aged between 16 and 47. The duration of disease varied from 1 to 20 years (mean: 4.46 years) and the treatment was applied for 3-9 months. The therapy was terminated due to depression (2 patients), extreme myalgia (1 patient), high level of triglycerides (2 patients), toxic hepatitis (3 patients). Recovery was achieved in 132 patients (88%) at the end of the treatment. The most commonly observed mucocutaneous side effects were cheilitis (100%), xerosis (56%), nose bleeding (34.8%), dermatitis (31%), and xerophthalmia (28%), beside the systemic side effects such as myalgia (45%), weakness (40%), and nervousness (36%). Side effects usually occurred within the early months and then diminished in course of time. The mostly seen laboratory abnormality was hypertrigliceridemia. Conclusion: Isotretinoin is the most commonly used treatment modality, which provides definitive benefits in many patients with acne. However, it should be used carefully, because it affects various systems. Although the drug has plenty of side effects, they are reversible and can be controlled. To raise awareness of the patients of these side effects will help to increase their tolerance. (Turkderm 2011; 45: 37-42)