Unsuccessful treatment of progressive macular hypomelanosis with oral isotretinoin

Damevska, Katerina; Pollozhani, Nora; Neloska, Lence; Duma, Silvija

doi:10.1111/dth.12514

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…Oral isotretinoin (0.4 mg kg –1 day –1 ) was initiated in a 22‐year‐old male, without improvement at a 3‐month follow‐up. That was the same result after 2 years course of therapy (Damevska, Pollozhani, Neloska, & Duma, ). These contradictory responses to isotretinoin may be related to different genomic characteristics of C. acnes subtypes (Zhao et al, ).…”

Section: Indications Of Low‐dose Isotretinoin In Dermatologysupporting

confidence: 72%

Low dose of isotretinoin: A comprehensive review

Abdelmaksoud

Lotti

Anadolu

et al. 2020

Dermatologic Therapy

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Isotretinoin is a first‐generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti‐inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date‐unlimited PubMed search, from inception till December 2019, using the following search terms: “low‐dose isotretinoin” and “dermatology,” “isotretinoin and safety,” “isotretinoin, off‐label uses,” “isotretinoin and male fertility,” “isotretinoin, iPLEDGE system,” aiming to deliver a therapeutic update relevant to clinical practice. All English‐language articles were considered with no limitation based on the articles' type. Low‐dose isotretinoin is not limited to old and novel dermatological conditions, but also showed promising results in the field of infertility and safety in the field of gastroenterology. We also highlight on the safety profile of the drug and experts' recommendations to enhance safety measures to decrease fetal risk while on isotretinoin.

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Section: Indications Of Low‐dose Isotretinoin In Dermatologysupporting

confidence: 72%

Low dose of isotretinoin: A comprehensive review

Abdelmaksoud

Lotti

Anadolu

et al. 2020

Dermatologic Therapy

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“…28,29 Attempts to treat PMH using oral isotretinoin have also been described in the literature, but the results obtained have been variable. [30][31] The hunt for a novel Cutibacterium species associated with PMH A conundrum in the proposal that C. acnes is the cause of PMH has been why the disorder, unlike acne, rarely affects the face where levels of the bacterium are at their highest, and why acne does not predispose individuals to PMH development. This led Relyveld et al 32 to suggest that the organism potentially causing PMH may not actually be C. acnes, but a closely related Cutibacterium species indistinguishable by conventional phenotypic/ biochemical methods.…”

Section: Therapeutic Success Of Antimicrobial-based Treatmentsmentioning

confidence: 99%

“…In particular, treatment of PMH with a combination of oral lymecycline (300 mg/day) and topical 5% BPO was very successful leading to repigmentation and maintenance during a 6‐to‐12 month follow‐up period 28,29 . Attempts to treat PMH using oral isotretinoin have also been described in the literature, but the results obtained have been variable 30–31 …”

Section: Evidence Supporting a Potential Role For Cutibacterium Acnes...mentioning

confidence: 99%

IsCutibacterium(previouslyPropionibacterium)acnesa potential pathogenic factor in the aetiology of the skin disease progressive macular hypomelanosis?

McDowell

McLaughlin

Layton

2020

Acad Dermatol Venereol

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Progressive macular hypomelanosis (PMH) is a skin condition that normally causes symmetrically distributed hypopigmented macules on the front and back of the trunk, but rarely the face. To date, the pathophysiology of the condition is not well understood, but a role for the anaerobic skin bacterium Cutibacterium (previously Propionibacterium) acnes in the development of the disease has been proposed due to its sole presence within lesional, but not normal peri‐lesional, skin. The success of antimicrobials in the treatment of PMH also provides circumstantial evidence that this association may be causal, although this is still to be proven. More recent culture and metagenomic typing studies indicate that strains of C. acnes subsp. elongatum (type III) may be important in the aetiology of the condition, which would help to explain why PMH does not normally affect the face since such strains are rarely present there, and why no association between this condition and acne vulgaris is found; acne appears to primarily involve type IA1 strains from C. acnes subsp. acnes (type I). In this review, we summarize current knowledge on the relationship between C. acnes and PMH, and re‐examine previous challenges to the view that the bacterium plays a role in the condition against the backdrop of newly emerged data.

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Dermatological indications for the use of isotretinoin beyond acne

Forbat

Ali

Al‐Niaimi

2018

Journal of Dermatological Treatment

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While the use of isotretinoin has revolutionized the treatment of acne vulgaris, isotretinoin is increasingly recognized as a useful therapeutic option for many other cutaneous conditions. We review the evidence underlying the use of isotretinoin for a variety of dermatological indications including hidradenitis suppurativa, sebaceous gland pathology, rosacea, scarring alopecia, cosmetic dermatology, and non-melanoma skin cancer prophylaxis amongst other uses, and thus consider alternative uses within dermatology practice. The studies found benefit of isotretinoin, however most trials lacked statistical power and in many cases the use was limited to case series. Isotretinoin, if used within the correct cohort with appropriate pretreatment counseling regarding side-effects, is a well-tolerated medication with potential as either an adjunctive treatment or a second-line agent in those recalcitrant cases unresponsive to first-line therapy.

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Unsuccessful treatment of progressive macular hypomelanosis with oral isotretinoin

Cited by 3 publications

References 5 publications

Low dose of isotretinoin: A comprehensive review

Low dose of isotretinoin: A comprehensive review

IsCutibacterium(previouslyPropionibacterium)acnesa potential pathogenic factor in the aetiology of the skin disease progressive macular hypomelanosis?

Dermatological indications for the use of isotretinoin beyond acne

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