isotretinoin and Epidermolysis-Bullosa

We report a case of a bullous variant of transient acantholytic dermatosis in a 59-year-old female. Each bullous lesion lasted several weeks and healed without scarring. The lesions were migratory and recurrent without a cleared period. Histopathologic examination revealed an intraepidermal vesicle low in the epidermis. The lesions cleared after 2 months of isotretinoin therapy.

Topics: Epidermolysis Bullosa; Female; Humans; Isotretinoin; Middle Aged; Penicillins; Recurrence; Skin

Transient acantholytic dermatosis is a self-limiting benign disease. It is characterized by multiple pruritic erythematous papules and papulovesicles found predominantly on the trunk and extremities. This primary acantholytic dermatosis affects individuals older than 40 years. We present a case study of an individual who received a regimen of isotretinoin (Accutane) for treatment of severe pruritus after conventional forms of therapy failed to alleviate his condition and abate the formation of new lesions.

Topics: Epidermolysis Bullosa; Humans; Isotretinoin; Male; Middle Aged

Topics: Epidermolysis Bullosa; Female; Humans; Isotretinoin; Middle Aged; Tretinoin

The effects of a variety of retinoids on collagenase and gelatinase expression have been examined in skin fibroblast cultures derived from normal volunteers and from patients with the hereditary blistering disorder, recessive dystrophic epidermolysis bullosa. Both 13-cis- and all-trans-retinoic acid were effective inhibitors of collagenase production in both cell types. In the case of collagenase, the inhibition of collagenase activity was paralleled by a reduction in immunoreactive enzyme protein, suggesting that these retinoids act by inhibiting synthesis and/or secretion of the enzyme. Retinoic acid also inhibited production of the second enzyme in the collagen degradative pathway, gelatinase. In this case, the decrease in gelatinase activity was equal to or slightly greater than the achieved in collagenase expression. The observation that certain retinoids modulate the two crucial enzymes in the degradation of collagen in the skin suggests that they might be useful therapeutic agents in recessive dystrophic epidermolysis bullosa, a disease in which the pathogenesis of blistering is in part related to connective tissue destruction.

Topics: Cells, Cultured; Epidermolysis Bullosa; Fibroblasts; Gelatinases; Humans; Isomerism; Isotretinoin; Microbial Collagenase; Pepsin A; Skin; Tretinoin; Vitamin A