Evaluation of Nasal Mucociliary Clearance, Nasal Obstruction Symptom Evaluation, and Epistaxis Severity Score in Isotretinoin Treatment

Abstract

Objectives: The study aims to investigate the possible side effects of isotretinoin use on the nasal mucosa with objective methods in the treatment of acne vulgaris. Methods: Before the treatment, nasal mucociliary clearance time (MCT) was measured in all patients. Also all patients were asked to complete the questionnaires about the nasal dryness (visual analog scale [VAS]), nasal obstruction (Nasal Obstruction Symptom Evaluation [NOSE]), and presence of epistaxis (Epistaxis Severity Score [ESS]). Both MCT and questionnaires were reevaluated in patients who completed the treatment. Results: The results of 101 patients were evaluated. Before treatment, mean duration of nasal mucociliary clearance (NMC) was 9.55 ± 1.30 minutes, nasal dryness (VAS) value was 2.7 ± 0.7, NOSE score was 2.1 ± 1.1, and ESS score was 1.2 ± 0.7; after treatment, the duration of NMC was 13.80 ± 2.29 minutes, VAS value was 3.3 ± 1.1, NOSE score was 3.2 ± 1.3, and ESS score was 2.1 ± 1.2 ( P = .018, .150, .027, .011, respectively). Conclusion: The nasal mucosa is adversely affected in patients due to regular use of isotretinoin in the acne treatment, anamnesis should be checked in all nasal surgeries, and routine ear nose throat control should be recommended for these patients.

Prevalence and factors associated with olfactory impairment among patients with acne treated with oral isotretinoin: a cross-sectional study

“…The negative impacts of ISO on olfactory function could also be attributed to nasal obstruction, and other mucosal changes, as documented in related investigations regarding qualitative olfactory dysfunction, obstruction, epistaxis, and xerosis of the nasal mucosa, which might contribute to a decrease in the sense of smell. 9 , 24 , 25 Indeed, an ideal balance of the nasal fluid is essential for good olfactory function. To improve the capture of odorants, a water-soluble medium would be more suitable, but not so exaggerated to avoid excessive congestion that might impede the odorants’ access to the olfactory receptors.…”

Clinical Characteristics and Risk Factors for Allergic Rhinitis in Children with Epistaxis

“…A visual analog scale (VAS) of individual nasal symptoms ranging from 0 (minimal) to 10 (extremely bothersome) was used to assess their severity. Individuals with scores of 0–4 were considered to have mild symptoms, while scores of 5–10 indicated moderate/severe symptoms [ 14 ]. Epistaxis severity was assessed using the ESS, and the scoring system ranged from 0 (no epistaxis) to 10 (most severe epistaxis).…”

“…Epistaxis severity was assessed using the ESS, and the scoring system ranged from 0 (no epistaxis) to 10 (most severe epistaxis). Scores of 1–3 indicated mild epistaxis, 4–7 indicated moderate, and 8–10 indicated severe [ 14 ].…”

Systemic isotretinoin therapy in the era of COVID‐19

“…12 Nasal moisturizers (D-panthenol, vaseline, glycerin, hypertonic solutions, and hyaluronic acid) are also recommended for these patients before starting isotretinoin, during the treatment, and for few months after the end of the treatment, as recommended by otorhinolaryngologist. 13 Coronavirus may be also detected in the nasal discharge of 15 Olfactory dysfunction can be a possible phenotypic marker of folate deficiency in treatment-resistant depression. 16 Isotretinoin has an enhancing effect on olfactory function in acne patients.…”