Acne is the most prevalent skin disorder affecting primarily adolescents and young adults. Side effects of acne, such as scarring, dyspigmentation, and low self-esteem, can cause severe morbidity. Isotretinoin is a medication that is used to treat severe acne. The medicine was licensed by the Food and Drug Administration in 1982 to treat severe nodular acne that had been resistant to other treatments, including systemic antibiotics. Other indications of isotretinoin include moderate acne, cutaneous T-cell lymphomas, neuroblastoma, and the prevention of squamous cell carcinoma in high-risk patients. Rosacea, folliculitis, and pyoderma faciale have all been treated with isotretinoin. Some side effects are also associated with the use of isotretinoin including teratogenicity the most severe one. The purpose of this research is to review the available information about indication, contraindication, complication and monitoring of Isotretinoin. Various dermatological conditions are also treated with isotretinoin apart from the common indication of acne. Complete blood count along with the lipid profile, and liver function test are monitored in patients on isotretinoin therapy. Dry lips and dry skin are among the common side effects of isotretinoin. Due to the severe complication of teratogenicity isotretinoin is contraindicated among pregnant women. Evidence from the literature suggests that isotretinoin is the effective medication in treatment of acne and low dose of isotretinoin does not cause any complication. Evidence-based guidelines and strategies for safety and efficacy of isotretinoin can be developed by further clinical research and trials.
Although pruritis might not be a serious condition with significant healthcare impacts, it is usually associated with an unpleasant sensation that leads to scratching the skin. It has been demonstrated that the severity of the condition is significantly variable and ranges between disabling and mild conditions. Chronic pruritis has been defined as the presence of daily itching for >6 months. In the present literature review, we have discussed the different approaches that have been previously indicated to assess and evaluate chronic pruritis, and the classification of the condition its relation to the different systemic diseases. The classification of chronic pruritis can be done using a clinical or an etiological diagnosis. The clinical diagnosis is usually based a primary skin condition, while the etiological diagnosis is based on the presence of different diseases that may be systematic, neurological, or psychiatric disorders. Accordingly, conducting a thorough examination is essential to establish a proper diagnosis before adequately managing the affected patients. Furthermore, the treatment of the underlying etiology should also be adequately considered for adequate management and enhanced prognosis.
Autoimmune diseases during childhood are common and are usually observed to affect multiple systems. Among many pediatric autoimmune diseases, several cutaneous manifestations were reported in the literature, and the adequate examination and detection of these manifestations might significantly enhance the chances of establishing an adequate diagnosis of the underlying diseases and conditions because the affected patients usually present with typical symptoms. Establishing a proper diagnosis can enhance the prognosis of the affected patients and might prevent the development of serious complications and other adverse events. Besides, it was also previously indicated that establishing an early diagnosis will furtherly help with deciding the most appropriate interventions, which will also enhance the prognosis of the pediatric population. In this literature review, we have discussed the cutaneous manifestations of several autoimmune diseases that might affect the pediatric population. We have majorly discussed the conditions that are associated with systemic lupus, juvenile idiopathic arthritis, dermatomyositis, juvenile-onset systemic sclerosis and morphea. The cutaneous manifestations of these conditions are hugely variable and usually need careful examination and adequate differential diagnosis to establish the best management modality. Besides, some manifestations might gradually develop which might even make the diagnostic approaches even more difficult. Accordingly, clinicians should provide full and thorough examination and diagnosis of the suspected patients because detecting such cases might significantly enhance the prognosis and lead to adequate treatment.
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