isotretinoin and Condylomata-Acuminata

Systemic isotretinoin has been used to treat severe acne vulgaris for 20 years. However, isotretinoin also represents a potentially useful choice of drugs in many dermatologic diseases other than acne vulgaris. Diseases such as psoriasis, pityriasis rubra pilaris, condylomata acuminata, skin cancers, rosacea, hidradenitis suppurativa, granuloma annulare, lupus erythematosus and lichen planus have been shown to respond to the immunomodulatory, anti-inflammatory and antitumor activities of the drug. Isotretinoin also helps prevent skin cancers such as basal cell carcinoma or squamous cell carcinoma. A combination of systemic isotretinoin and interferon-alpha-2a may provide a more potent effect than isotretinoin alone in the prevention and treatment of skin cancers.Systemic isotretinoin may be considered as an alternative drug in some dermatologic diseases unresponsive to conventional treatment modalities. However, randomized clinical trials aimed at determining the role of systemic isotretinoin therapy in dermatologic diseases other than acne vulgaris are required.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Inflammatory Agents; Condylomata Acuminata; Dermatologic Agents; Drug Therapy, Combination; Granuloma Annulare; Hidradenitis Suppurativa; Humans; Isotretinoin; Keratolytic Agents; Lichen Planus; Lupus Erythematosus, Systemic; Pityriasis Rubra Pilaris; Psoriasis; Rosacea; Sebaceous Glands; Skin Diseases; Skin Neoplasms

Although oral isotretinoin has been considered as a potential therapeutic option for the treatment of different types of warts, the optimum dosage regimen is not yet well-established. To evaluate the efficacy and adverse effects of high versus low doses of oral isotretinoin in the treatment of cutaneous and genital warts. The study included 100 patients who were randomly assigned to two groups, 50 patients in each. Group 1 received 0.6 mg/kg/day (high dose isotretinoin) and Group 2 received 0.3 mg/kg/day (low dose isotretinoin). In both groups, therapy was given daily until resolution was achieved or for a maximum of 3 months. Complete clearance of warts was observed in 76% of the high dose isotretinoin group and in 46% of the low dose isotretinoin group. There was a statistically significant difference in the therapeutic response between the two groups. Recurrence was higher in the low dose group (26%) than the high dose group (7.8%). Adverse effects were mild and tolerable. High dose of systemic isotretinoin is more effective than low dose and seems to be a promising well-tolerated and effective therapeutic option for the treatment of cutaneous and genital warts.

Topics: Administration, Oral; Condylomata Acuminata; Dermatologic Agents; Humans; Isotretinoin; Papillomaviridae; Warts

Anogenital warts are a common human papillomavirus infection. They cause emotional distress, especially when they are in the anogenital region. Cryotherapy is a first-line treatment. Previous clinical trials and case series have reported variable results with retinoids (isotretinoin) as adjuvant therapy.. To determine the safety and efficacy of low-dose oral isotretinoin as adjuvant treatment of anogenital warts.. Forty-six patients with anogenital warts were randomly assigned to isotretinoin + cryotherapy (n = 23) or only cryotherapy (n = 23). Patients were allocated via an interactive web-based randomization system. Evaluators were blinded to treatments. Isotretinoin 20 mg/daily + cryotherapy or cryotherapy were prescribed for 6 weeks. Patients were followed for 4 months. Genotyping of lesions was performed before treatment started. Dermatology Life Quality Index (DLQI) and Columbia-Suicide Severity Rating Scale (C-SSRS) were measured at the beginning and end of therapy. All patients completed the study.. Both Groups had 50% clearance at the end of treatment. Recurrence in the combined group was not significantly lower than in the cryotherapy group (P = 0.59). Improvement was observed in the DLQI of all patients in both groups (P = 0.001). No suicidal intention was detected with the C-SSRS. Two patients (one in each group) had liver function test abnormalities after treatment.. Combined therapy showed a slight not significant efficacy for anogenital warts in Hispanic patients. Low-dose isotretinoin seems to be safe even when it is used with cryotherapy on anogenital warts.. On April 25, 2019 with registration number DE19-00004, CONBIOÉTICA-19-CEI-001-20160404. Prospectively registered.

Topics: Administration, Oral; Adult; Combined Modality Therapy; Condylomata Acuminata; Cryotherapy; Dose-Response Relationship, Drug; Female; Humans; Isotretinoin; Male; Middle Aged; Prospective Studies; Quality of Life; Recurrence; Severity of Illness Index; Treatment Outcome; Young Adult

Conventional therapies for human papillomavirus (HPV) infection are often associated with unsatisfactory response rates and high recurrence rates. The use of a systemic agent may more effectively control the virus.. To investigate the efficacy and safety of low dose oral isotretinoin in recalcitrant condylomata acuminata (RCA) of the cervix.. Double blind placebo controlled clinical trial. 60 women, aged 21-43 years, with RCA of the cervix, refractory to at least one conventional therapy, were randomly assigned to receive either isotretinoin, 0.5 mg/kg daily for 12 weeks (group 1), or placebo (group 2).. Of the 28 evaluable group 1 patients, nine (32.1%) responded to the treatment completely, 11 (39.2%) responded partially, and eight (28.5%) did not respond. Of the 25 group 2 patients, no one responded to the treatment completely, two (8%) responded partially, and 23 (92%) did not respond. The therapeutic difference between patients receiving active and placebo therapy was statistically significant (chi(2) = 19.35, p<0.001). Only one (11.1%) of the complete responders experienced recurrence during the 12 month follow up. Side effects were generally mild and resolved upon completion of therapy.. Compared to placebo, low dose oral isotretinoin showed considerable efficacy with insignificant and reversible side effects and a low recurrence rate. Isotretinoin may represent an efficacious and safe alternative systemic form of therapy for RCA of the cervix.

Topics: Administration, Oral; Adult; Anti-Infective Agents; Condylomata Acuminata; Double-Blind Method; Female; Humans; Isotretinoin; Treatment Outcome; Uterine Cervical Diseases

The aim of our study was to evaluate the efficacy and safety of oral isotretinoin in the treatment of condylomata acuminata.. A total of 56 male patients with a history of condylomata acuminata refractory to at least 1 standard therapeutic regimen was treated orally with isotretinoin (1 mg./kg. daily) during a 3-month period.. At the end of treatment 21 of the 53 evaluated patients (39.6%) had complete response, 7 (13.2%) had partial response and 25 (47.1%) had no response. A statistically significant inverse relationship was found between age and area of treated lesions and response to medication. Two complete responders (9.5%) revealed recurrence during the 1-year followup.. Oral isotretinoin may be regarded as an effective, fairly well tolerated and noninvasive alternative form of therapy for immature and small condylomata acuminata.

Topics: Administration, Oral; Adult; Condylomata Acuminata; Genital Diseases, Male; Humans; Isotretinoin; Male; Middle Aged

We attempted to test the hypothesis that the combination of systemic interferon alfa-2a and oral isotretinoin is more effective than isotretinoin alone in the treatment of recurrent condylomata accuminata.. Fifty seven women with recurrent condylomata accuminata were randomly assigned in two groups. Group A (n = 24) received isotretinoin alone (Roaccutan, Roche) 1 mg/kgr orally daily for 3 months or until a remission was achieved; Group B (n = 33) received Interferon alfa-2a (Roferon-A, Roche) 3 million units subcutaneously three times for 8 weeks plus isotretinoin 1 mg/Kg orally for 3 months or until a remission was achieved.. There was no statistically significance in remission rates between the two groups (18/24 vs 28/33, p > 0.1). However the duration of treatment was statistically significantly shorter in Group B (1.9 vs 2.5 months, p < 0.01). Side effects were minimal.

Topics: Adolescent; Adult; Condylomata Acuminata; Female; Humans; Interferon alpha-2; Interferon-alpha; Isotretinoin; Recombinant Proteins; Recurrence

Purpose of the present study was to evaluate the effectiveness of isotretinoin versus interferon alfa-2a plus isotretinoin in the treatment of recurrent condyloma acuminatum in 86 men.. Men were randomly assigned to group A (n = 42) who received isotretinoin 1 mg/kg orally daily until remission was achieved, but not more than 3 months, or to group B (n = 44) who received interferon alfa-2a 3 x 10(5) IU subcutaneously three times weekly until remission was achieved, but not more than 8 weeks, plus isotretinoin in the same dosage as in group A.. The reduced duration of treatment to achieve remission was statistically significant in group B (2.18 versus 2.5 months; P < 0.01) and the recurrence rate was less in group B (4 of 44 versus 16 of 42; P < 0.01).. The results of this study are encouraging and demonstrated that the combination of isotretinoin plus interferon alfa-2a achieves higher remission rates and a shorter duration of treatment than isotretinoin alone.

Topics: Adolescent; Adult; Combined Modality Therapy; Condylomata Acuminata; Follow-Up Studies; Genital Diseases, Male; Humans; Interferon alpha-2; Interferon-alpha; Isotretinoin; Male; Recombinant Proteins; Recurrence; Remission Induction; Time Factors

This study evaluated the effectiveness of systemic interferon alfa-nl versus isotretinoin in the treatment of condylomata acuminata. Patients were randomly assigned interferon alfa-nl, 5 million units, subcutaneously daily for 2 weeks then twice weekly for 4 weeks, or isotretinoin, 1 mg/kg by mouth daily for 6 weeks. Seventeen otherwise healthy men with histologically confirmed condylomata acuminata refractory to standard treatment completed 6 study weeks. Five of nine men (56%) treated with interferon alfa-nl had an objective clinical response (greater than or equal to 50% clearance of baseline disease), with one patient clearing completely. None of the patients treated with isotretinoin alone had an objective response (p = 0.009). Those whose clearing was incomplete with interferon alone were then assigned to interferon therapy three times weekly in combination with daily isotretinoin for 6 weeks, and those receiving isotretinoin were switched to interferon three times weekly for 6 weeks. There was continued clearing in all patients in the combination treatment group but in only three of seven in the sequential treatment group. Side effects were common and generally predictable for each drug but were generally not exacerbated when interferon and isotretinoin were used in combination. Parenteral interferon alfa-nl is an effective alternative treatment modality for patients with refractory condylomata acuminata.

Topics: Adult; Condylomata Acuminata; Drug Evaluation; Drug Therapy, Combination; Humans; Interferon Type I; Isotretinoin; Male; Middle Aged; Penile Neoplasms; Random Allocation

Topics: Administration, Topical; Aminoquinolines; Condylomata Acuminata; Humans; Imiquimod; Isotretinoin; Remission Induction

Erythema nodosum (EN) is a form of septal panniculitis, which is believed to represent a delayed hypersensitivity reaction activated by infectious agents, drugs, granulomatous and autoimmune diseases, pregnancy, and malignancies. There are only four reported cases of EN during oral isotretinoin therapy to our knowledge, all of them occurring in patients with severe acne. Since acne itself can trigger EN, the question as to whether there is indeed a causative relationship between isotretinoin and EN in the reported cases remains to be elucidated. We present herein a 20-year-old woman with multiple vulvar condylomata acuminata who developed EN two weeks after onset of oral isotretinoin therapy. To the best of our knowledge, this is the first report of EN occurring during isotretinoin treatment in a patient without acne and strongly indicates that the pathogenesis of EN can be directly related to the biological actions of isotretinoin. Erythema nodosum should be regarded as a rare side effect of oral isotretinoin therapy, regardless of the underlying disease. Physicians should be aware of this rare side effect.

Topics: Administration, Oral; Biopsy; Condylomata Acuminata; Dermatologic Agents; Erythema Nodosum; Female; HIV Seronegativity; Humans; Isotretinoin; Skin; Young Adult

Topics: Administration, Cutaneous; Administration, Oral; Condylomata Acuminata; Dermatologic Agents; Drug Therapy, Combination; Humans; Isotretinoin; Keratolytic Agents; Male; Penile Diseases; Podophyllin; Recurrence

Topics: Adult; Antiviral Agents; Condylomata Acuminata; Dermatologic Agents; Drug Therapy, Combination; Female; Human papillomavirus 11; Humans; Interferon-alpha; Isotretinoin; Young Adult

The treatment of condyloma acuminatum may be problematic in clinical practice. We present a 27-year-old man with condyloma acuminatum who was treated successfully with a combination therapy of isotretinoin and interferon-alfa-2a. In the previous reports of combination therapy, isotretinoin has been given in a dosage of 1 mg/kg/day. However, we achieved the same success at a dosage of 0.5 mg/kg/day of isotretinoin.

Topics: Adult; Antiviral Agents; Condylomata Acuminata; Humans; Interferon alpha-2; Interferon-alpha; Isotretinoin; Male; Penile Diseases; Recombinant Proteins