Does topical isotretinoin exposure during pregnancy increase the risk of congenital malformations?

Abstract

A 34-year-old patient who learned that she was 7 weeks pregnant while she was using topical isotretinoin + erythromycin gel for acne treatment was referred to İzmir Katip Çelebi University Teratology Information Service for information regarding the risk of teratogenicity. Systemic use of isotretinoin is well-known for its teratogenic effects and case reports suggesting possible teratogenic effects in case of topical exposure to retinoids in pregnancy exist in the literature. However, findings reported in four prospective controlled studies do not suggest an increased congenital malformation risk in case of inadvertent exposure during pregnancy. This manuscript aims to give a summary and evaluation of available data for counseling pregnant patients regarding the possible teratogenic risk of inadvertent topical isotretinoin exposure during pregnancy. It also aims to emphasize the importance of increasing communication between pregnant patients, clinicians and teratology information services for the benefit of mother and unborn. (Turkderm 2015; 49: 92-4)