A POTENTIAL FOR THE SHORTEST TREATMENT OF MODERATELY SEVERE ACNE VULGARIS WITH THE USE OF MINIMUM- AND LOW-DOSE OF ISOTRETINOIN

Faraedon Kaftan*

*Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.


A POTENTIAL FOR THE SHORTEST TREATMENT OF MODERATELY SEVERE ACNE VULGARIS WITH THE USE OF MINIMUM- AND LOW-DOSE OF ISOTRETINOIN


ABSTRACT


Background
Acne vulgaris is a common human skin disease. Isotretinoin is one of many pharmaceutical agents used in the treatment of patients with moderate and severe forms of acne.

Objectives
To use minimum- and low-dose of isotretinoin for the shortest period in the treatment of patients with moderate acne vulgaris.

Patients and methods
We have carried out this study on 210 patients with moderate papulopustular acne. From the beginning to compare between the patients they were divided into two age groups: the first group between 12 and 20 years; the second group between 21 and 35 years. Both groups of patients were followed up for four years. All patients were treated for 4 months with isotroin capsules with a dosage of 40 mg/day in two divided doses for two months and then decreased to 20 mg/day for another two months. Before and after the two and four months treatment laboratory tests were carried out for complete blood cell counts, liver and lipid profiles (cholesterol and triglycerides). Pregnancy tests were also carried out before treatment in female patients of child-bearing potential and interested in this regimen.

Results
The first group included 110 patients, with a female/male ratio of 2:1, mean age 17.2 years, and a mean body weight of 56.3 kg. 99.1% of the patients achieved complete remission, whilst 0.9% of the patients failed to respond to the treatment. The relapse rate was 3.6% and the mean total dosage of isotroin was 63.9 mg/kg, whereas and the daily dose of the drug was 0.5 mg/kg/day. The second group included 100 patients, with a female/male ratio of 2.6:1, mean age 25.3 years, and a mean body weight of 66.8 kg. 99% of the patients achieved complete remission, whilst 1% of the patients failed to respond to the treatment.
The relapse rate was 4%, the mean total dosage of isotroin was 53.9 mg/kg and the daily dose of the drug was 0.45 mg/kg/day. In both groups, the most common side effects in all the patients were mild to severe cheilitis and dryness of the skin. Only one patient suffered of epistaxis. After the 4-month treatment only one of the patients had high serum triglycerides. None of the patient had elevation of liver enzymes.

Conclusion
In moderately severe acne vulgaris, excellent results can be obtained with minimum- and low-dose oral isotretinoin for only four months of treatment.

Keywords: Isotretinoin, Moderate acne vulgaris.


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Kewan Omer,
Jan 23, 2015, 1:27 PM