isotretinoin and Diabetes-Mellitus--Type-1

A case of acquired perforating dermatosis associated with diabetic nephropathy is described. The case is unusual in that the dermatosis first developed approximately 1 year after renal transplantation rather than at a time when renal function was more severely impaired or during haemodialysis. There was a partial response to treatment with isotretinoin but the use of this drug was limited by the development of hyperlipidaemia. The relevant literature is reviewed.

Topics: Adult; Diabetes Mellitus, Type 1; Diabetic Nephropathies; Humans; Hyperlipidemias; Isotretinoin; Keratolytic Agents; Kidney Failure, Chronic; Male; Skin Diseases

Topics: Baths; Calcinosis; Cat-Scratch Disease; Child; Diabetes Mellitus, Type 1; Folliculitis; Foot Dermatoses; Herpes Simplex; Humans; Hyperhidrosis; Isomerism; Isotretinoin; Joint Diseases; Lyme Disease; Skin Diseases; Tinea; Tretinoin

Topics: Acne Vulgaris; Blood Glucose; Dermatologic Agents; Diabetes Mellitus, Type 1; Female; Humans; Insulin; Insulin Resistance; Isotretinoin; Young Adult

Latent autoimmune diabetes in adults (LADA) is the most common form of adult-onset autoimmune diabetes. Isotretinoin is a very effective treatment for severe acne. There are various reports on the effect of isotretinoin on autoimmunity. We present a case of LADA, probably related to isotretinoin treatment. To the best of our knowledge, this case was the second case of LADA that occurred after isotretinoin treatment. Here we discuss a hypothesis on the pathophysiology of how isotretinoin can induce LADA.. A 55-year-old female was diagnosed with type 2 diabetes mellitus (T2DM) one month after the end of a nine-month isotretinoin treatment period. At the time of diagnosis, the patient's fasting blood glucose level was 257 mg/dL and HbA1c level was 10.3%. Then, she was followed-up for T2DM for two years. Since the patient did not comply with classical T2DM characteristics and C-peptide level was 0.4 ng/ml (0.78-5.18), autoantibody test was performed. The patient was found positive for anti-glutamic acid decarboxylase antibody (>2000 IU/mL). Her oral antidiabetic drug treatment was discontinued and insulin degludec and insulin aspart therapy was started. Three months after this adjustment, HbA1c level decreased to 7.2%. Except 25-hydroxycholecalciferol which was low (10.9 ng/mL), all other laboratory parameters were within normal range.. Isotretinoin is known to have some immunomodulating effects. There are some case reports on the relationship between isotretinoin and autoimmune diseases. The negative immune environment that developed due to the long-standing moderate-severe VitD deficiency may have taken a turn toward autoimmunity upon isotretinoin treatment. This hypothesis on how isotretinoin can cause autoimmune diabetes needs to be validated.

Topics: Adult; Autoantibodies; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Glucose Intolerance; Humans; Isotretinoin; Latent Autoimmune Diabetes in Adults; Middle Aged

Topics: Acne Vulgaris; Administration, Oral; Adult; Cholesterol, HDL; Diabetes Mellitus, Type 1; Humans; Insulin Resistance; Isotretinoin; Male

Topics: Acne Vulgaris; Administration, Oral; Adult; Diabetes Mellitus, Type 1; Female; Graft Rejection; Humans; Immunosuppressive Agents; Isotretinoin; Keratolytic Agents; Kidney Transplantation