isotretinoin and Epidermolysis-Bullosa-Dystrophica

Patients with recessive dystrophic epidermolysis bullosa (RDEB) are at high risk of developing squamous cell carcinoma on or after midadolescence, and most patients die of metastatic squamous cell carcinoma within 5 years of diagnosis of their first squamous cell carcinoma.. We sought to determine whether isotretinoin can be safely administered to patients with RDEB as a possible chemopreventive agent.. A total of 20 patients with RDEB aged 15 years or older were treated daily for 8 months with isotretinoin (with a targeted dosage of 0.5 mg/kg/d).. No unusual adverse reactions were noted in this patient population. Several patients experienced reduced blistering at lower doses and increased mechanical fragility at maintenance dosage.. Isotretinoin, at least up to a dosage of 0.5 mg/kg/d, may be safely used in patients with RDEB. Although increased fragility may occur, patients tolerated this drug well and were receptive to its long-term use for possible chemoprevention of cancer. Whether such an effect will occur is yet to be proven.

Topics: Adolescent; Adult; Aged; Carcinoma, Squamous Cell; Dermatologic Agents; Epidermolysis Bullosa Dystrophica; Female; Humans; Isotretinoin; Male; Middle Aged; Risk Factors; Skin Neoplasms