Isotretinoin Treatment of Acne and Related Disorders: An Update

The 1983 document reports that isotretinoin is highly effective in treating severe nodulocystic acne and related disorders such as acne rosacea and gram-negative folliculitis. Approximately 200,000 patients had been treated with isotretinoin by mid-1983, with a recommended daily dose of 1 mg/kg for 16 to 20 weeks, often resulting in significant improvement or total clearing of the condition. Side effects are common, affecting over 90% of patients, but are generally reversible upon discontinuation of the drug. These include mucocutaneous effects like cheilitis, dermatitis, and increased sun sensitivity, as well as more serious effects such as elevated serum triglycerides, liver function abnormalities, and teratogenicity, necessitating close monitoring and the use of contraception during treatment. Overdoses have caused symptoms like vomiting and headache, but recovery is typically rapid. The document emphasizes the importance of patient selection and monitoring, particularly of triglycerides to prevent pancreatitis, and concludes that isotretinoin is a useful adjunct therapy for severe acne and related papulopustular diseases with scarring.