Oral isotretinoin is as effective as a combination of oral isotretinoin and topical anti-acne agents in nodulocystic acne

Dhir, R.; Gehi, Neetu P; Agarwal, Reetu; More, Yuvraj E

doi:10.4103/0378-6323.39727

Cited by 22 publications

(14 citation statements)

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“…[6263] It is the only drug that affects all four pathogenic factors implicated in the etiology of acne.…”

Section: Systemic Therapymentioning

confidence: 99%

Acne vulgaris treatment : The Current Scenario

Rathi¹

2011

Indian J Dermatol

100

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Acne Vulgaris is one of the most common skin disorders which dermatologists have to treat. It mainly affect adolescent, though may present at any age. In recent years, due to better understanding of the pathogenesis of acne, new therapeutic modalities and various permutation and combinations have been designed. In topical agents; benzoyl peroxide, antibiotics, retinoids, etc are the mainstay of treatment; can be given in combinations. While systemic therapy includes oral antibiotics, hormonal therapy, and isotretinoin, depending upon the need of patients it has to be selected. Physical treatment in the form of lesion removal, photo-therapy is also helpful in few of them. Since various old and new topical and systemic agents are available to treat acne, it sometime confuse treating dermatologist. To overcome this, panel of physicians and researchers worked together as a global alliance and task force to improve outcomes in acne treatment. They have tried to give consensus recommendation for the treatment of acne. Successful management of acne needs careful selection of anti-acne agents according to clinical presentation and individual patient needs.

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“…[6263] It is the only drug that affects all four pathogenic factors implicated in the etiology of acne.…”

Section: Systemic Therapymentioning

confidence: 99%

Acne vulgaris treatment : The Current Scenario

Rathi¹

2011

Indian J Dermatol

100

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“…[1] This disease is a multifaceted disorder of the sebaceous glands. [2] Over the last 3 decades, scientific understanding of the pathogenesis of acne has increased considerably. Acne vulgaris is traditionally managed with a variety of topical and systemic medications.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of fixed daily 20 mg of isotretinoin in moderate to severe scar prone acne

et al. 2014

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Background:Despite advances in acne therapy in recent years, treatment failure is common. Isotretinoin is the only drug that affects almost all factors in acne pathogenesis, but side-effects are common at the doses reported in published studies in the literature. The aim of this study was to investigate the efficacy of low daily dose isotretinoin in moderate to severe acne patients. The secondary objective was to measure the rate of relapse 5 years after the completion of therapy.Materials and Methods:In this retrospective, noncomparative study, 146 patients with moderate to severe scare prone acne. Treatment regimen consisted of isotretinoin, fixed 20 mg daily, and duration of treatment-based on the weight of patient, until total cumulative dose of 120 mg/kg of body weight is achieved. No topical or other systemic therapy was allowed during the trial. Liver function tests (serum glutamic-oxalocetic transaminase, serum glutamate pyruvate transaminase, direct and total bilirubin), and lipid profiles (total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride) were evaluated for all patients, before the initiation of treatment and again after the 2nd month of treatment. All data analyzed by Microsoft Office Excel 2007; in descriptive statics frequency and SPSS.18 software.Results:At the end of treatment course, (96.4%) demonstrated complete clearing of their acne, defined as no acne or occasional isolated lesions. In 5-year follow-up, relapse accrued in 11 (7.9%) of patients. All adverse effects were mild, and discontinuation of treatment was not necessary.Conclusion:Low dose isotretinoin was found to be a safe and effective choice for patients with moderate to severe scar prone acne vulgaris.

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“…found no significant benefit in the combination of topical anti-acne and isotretinoin over isotretinoin alone in improving nodulocystic acne vulgaris. [4] However, in our study, the significant efficacy observed in the use of topical 5% dapsone in a similar setting in reducing the count of lesions in weeks 4, 8 and 12, is probably due to the additional anti-inflammatory effect of dapsone. In a study by Tanghetti et al .…”

Section: Discussionmentioning

confidence: 50%

“…Antibiotics play a pivotal role in treatment. [4] Dapsone (4, 4′-diaminodiphenylsulfone) is a drug of the sulfone class and was discovered in 1908. [5] Oral dapsone has demonstrated efficacy in acne, but was associated with severe side-effects such as anemia, which was particularly serious in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of 5% dapsone gel plus oral isotretinoin versus oral isotretinoin alone in acne vulgaris: A randomized double-blind study

et al. 2014

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Background:Acne vulgaris, a common human skin condition, is an inflammatory disease characterized by comedones, papules, nodules and possibly scarring.This study aimed to evaluate the efficacy of a combination of 5% dapsone gel plus oral isotretinoin in the treatment of acne vulgaris.Materials and Methods:A randomized, placebo-controlled, study was carried out on patients with moderate to severe acne. The patients were randomly divided in two groups: (dapsone gel and vehicle gel). All Patients were administered oral isotretinoin 20 mg daily and topical gel twice a day for 8 weeks. The Global Acne Assessment Score (GAAS), the number lesions and side-effects were documented at base line and weeks 4, 8 and 12.Results:A total of 58 patients (age range: 18-25 years) were included in our study. The number of lesions was significantly lower in the dapsone-treated group at all follow-up visits (P < 0.001). The mean GAAS score in the dapsone-treated group and in the Placebo-treated group decreased, but there was no statistical difference in two groups (P < 0.001). The side-effects on the dapsone-treated group were a mild burning sensation in 7 patients (24.13%), mild erythema of the skin and mild dryness in 4 (13.79%) and 3 (10.34%) cases respectively (P < 0.001). In our study, adverse effects were common but they were minor and tolerable. No clinically significant changes in laboratory parameters were observed (P < 0.001).Conclusions:Dapsone gel was an effective medication for patients who received isotretinoin for acne vulgaris treatment resulting in a significant reduction of the number of lesions.

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Oral isotretinoin is as effective as a combination of oral isotretinoin and topical anti-acne agents in nodulocystic acne

Abstract: Isotretinoin produces gratifying results in patients of nodulocystic acne in Indian conditions. Addition of topical antiacne agents does not alter the final outcome. This addition is well tolerated but requires careful monitoring.

Cited by 22 publications

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Acne vulgaris treatment : The Current Scenario

Acne vulgaris treatment : The Current Scenario

Efficacy of fixed daily 20 mg of isotretinoin in moderate to severe scar prone acne

The efficacy of 5% dapsone gel plus oral isotretinoin versus oral isotretinoin alone in acne vulgaris: A randomized double-blind study

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