Erdinc Terzi, Belma Tursen, Umit Tursen


Background: Isotretinoin is the most effective drug in severe acne vulgaris. Recently, its use has been extended for the treatment of chronic mild or moderate acne unresponsive to conventional antibiotic therapy. It has been reported that isotretionin treatment may lead to social phobia, depression, anxiety, tendency to suicide. In some patients, isotretinoin is not well tolerated due to its side effects. The objective of our trial was to asses the efficacy and safety of intermittent isotretinoin treatment and compare

them with standart isotretinoin therapy in moderate and severe acne cases.
Methods: In our trial, 84 patients with moderate to severe acne were randomized to receive isotretinoin 0.75 mg/kg/day for six months
(group 1, 45 patients) or 0.75 mg/kg, in the first 10 days of each month, for six months (group 2, 39 patients), according to the acne grades and number of inflammatory lesions. Patients were examined for clinical improvement, acne grades and side-effects at baseline, six months treatment period and during the monthly and yearly follow-up period in a three-month interval.

Results: All cases completed the six-month therapy. Acne severity scores were significantly decreased in both groups at the end of the treatment and follow-up period (p<0.001). Side effects were mild and discontinuation of the treatment was not necessary. There were no statistically significant differences between the two groups regarding treatment efficacy (p=0.524). The frequency and severity of isotretinoin related adverse effects were higher in group 1 compared to group 2.

Discussion: Intermittent isotretinoin treatment might be an alternative choice for moderate and severe acne vulgaris cases due to its low incidence and severity of adverse effects. It could be indicated in patients who cannot tolerate conventional treatment.

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