isotretinoin and Exanthema

Rosacea is a kind of chronic inflammatory skin disease that usually occurs in the middle of the face. Diammonium glycyrrhizinate (DG), an effective monomer component extracted from licorice, has extensive anti-inflammatory, antioxidant, anti-allergic, and immunomodulatory effects. There is no research on its therapeutic effect on rosacea. In this study, we divided rosacea patients mainly characterized by papules and pustules randomly into three groups. Group A received clarithromycin 500 mg once a day, isotretinoin 10 mg once a day; Group B received DG 150 mg three times a day, other medicines were the same as Group A; Group C received clarithromycin 250 mg once a day, isotretinoin 10 mg once every 2 days, and DG 150 mg three times a day. All patients' symptom scores and laboratory tests were evaluated when followed up. We found that DG combined with clarithromycin and isotretinoin in the treatment of rosacea was more effective and quicker than clarithromycin and isotretinoin alone. Moreover, half common dosage of clarithromycin and isotretinoin combined with DG could achieve the same therapeutic effect as the conventional dose, and brought about lower incidences of adverse events (AEs). Therefore, it is recommended to use half common dosage of routine medication combined with DG for rosacea patients mainly characterized by papules and pustules.

Topics: Clarithromycin; Double-Blind Method; Exanthema; Glycyrrhizic Acid; Humans; Isotretinoin; Rosacea

A new treatment for cystic fibrosis combining 3 CFTR modulators-elexacaftor (ELX), tezacaftor (TEZ), and ivacaftor (IVA)-has recently been approved for cystic fibrosis treatment. The cutaneous adverse effects following treatment with this combination are poorly described in the literature.. To describe the clinicopathological features and treatment response of ELX-TEZ-IVA-associated acneiform eruptions in patients with cystic fibrosis.. This case series study was conducted in the Dermatology Department of Cochin Hospital, Paris, France, from July 2021 to June 2022 in collaboration with the Cochin Reference Center for Cystic Fibrosis. Referred patients were examined by senior dermatologists. All patients with cystic fibrosis treated with ELX-TEZ-IVA and referred for an acneiform rash were included.. Treatment with ELX-TEZ-IVA.. Onset of acneiform rash, type of lesions, and degree of severity, as well as treatments initiated and response, were evaluated. When performed, skin biopsies were reviewed.. This study included 16 patients (11 women [68.7%]) with a median (range) age of 27 (22-38) years. Six patients (37.5%) developed new-onset acneiform rashes, whereas 10 patients (62.5%) had a relapse (5 patients) or worsening (5 patients) of previous acne. The median (range) onset of acneiform rash was 45 (15-150) days. At inclusion, 11 patients (68.7%) had facial hyperseborrhea, 15 patients (93.7%) had noninflammatory lesions, and 14 (87.5%) had inflammatory lesions of seborrheic regions. Four patients (25.0%) had severe acne with deep inflammatory lesions and pitted scars. A specific pathological pattern of necrotizing infundibular crystalline folliculitis was observed in 4 patients. Topical acne treatments, antibiotics, and isotretinoin were used successfully in these patients, resulting in partial or complete remission in 12 patients (85.7% of patients reevaluated).. This case series study found that acneiform eruption is an adverse event associated with ELX-TEZ-IVA treatment in patients with cystic fibrosis. Most patients developed mild lesions. However, isotretinoin treatment may be necessary in some patients. The mechanism of ELX-TEZ-IVA-associated acneiform eruption is currently unknown, but the observation of necrotizing infundibular crystalline folliculitis in biopsied patients may guide further exploration.

Topics: Acne Vulgaris; Acneiform Eruptions; Adult; Cystic Fibrosis; Cystic Fibrosis Transmembrane Conductance Regulator; Drug Combinations; Exanthema; Female; Folliculitis; Humans; Isotretinoin; Male; Mutation; Young Adult

Topics: Exanthema; HIV Infections; Humans; Isotretinoin; Scleromyxedema

Lichen planus is an inflammatory disease affecting the skin and mucosal membranes often with a chronic course lasting months to years with episodes of relapses. Classically it presents as flat topped, purple, polygonal, pruritic papules on the volar aspect of wrists and forearms, ankles, lower legs, and lumbo-sacral spine. We report a young woman with an exanthematous/eruptive variant of lichen planus who had a sudden outbreak of multiple papules and plaques all over the body with relative sparing of head and neck region. Eruptive lichen planus is rarely reported in adults and effective treatments are not well documented. We prescribed a short course of oral corticosteroid to which the patient did not respond. This was followed by oral isotretinoin and there was dramatic improvement in her symptoms and cutaneous lesions. A short course of oral corticosteroid followed with oral isotretinoin may be considered as a valuable management plan for exanthematous lichen planus. This combination may avoid serious adverse effects of both drugs when prescribed in high doses.

Topics: Adrenal Cortex Hormones; Exanthema; Female; Humans; Isotretinoin; Lichen Planus; Skin

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Dermatologic Agents; Exanthema; Humans; Isotretinoin

Isotretinoin (13-cis-retinoic acid) is a synthetic vitamin A derivative that is effective in the treatment of recalcitrant, nodulocystic acne. To our knowledge, there are no reports in the medical literature of milia as a side effect of isotretinoin. We report a case of eruptive facial milia in the setting of isotretinoin treatment for acne.

Topics: Acne Vulgaris; Adolescent; Dermatologic Agents; Exanthema; Humans; Isotretinoin; Male

In recent years inhibitors directed against the epidermal growth factor receptor (EGFR) have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance as well as dose reduction or even termination of the anti-EGFR therapy. Yet, an effective dermatologic management of cutaneous adverse effects can be achieved. Whereas various case reports, case series or expert opinions on the management of EGFR-inhibitor (EGFRI) induced rashes have been published, data on systematic management studies are sparse.. Here, we present a retrospective, uncontrolled, comparative study in 49 patients on three established regimens for the management of EGFRI-associated rashes.. Strikingly, patients' rash severity improved significantly over three weeks of treatment with topical mometason furoate cream, topical prednicarbate cream plus nadifloxacin cream, as well as topical prednicarbate cream plus nadifloxacin cream plus systemic isotretinoin.. In summary our results demonstrate that EGFRI-associated rashes can be effectively managed by specific dermatologic interventions. Whereas mild to moderate rashes should be treated with basic measures in combination with topical glucocorticosteroids or combined regiments using glucocorticosteroids and antiseptics/antibiotics, more severe or therapy-resistant rashes are likely to respond with the addition of systemic retinoids.

Topics: Administration, Topical; ErbB Receptors; Exanthema; Fluoroquinolones; Humans; Isotretinoin; Mometasone Furoate; Pregnadienediols; Protein Kinase Inhibitors; Quinolizines

Erlotinib is useful in advanced non-small cell lung cancer although compliance and efficacy are diminished by skin rash in a high proportion of patients, often necessitating dose reduction or drug withdrawal. No effective treatment for the rash is available.. We carried out a preliminary investigation on isotretinoin and clindamycin. Among 56 advanced lung cancer patients treated with erlotinib, 31 (53%) developed rash. Seven (35%) of the 20 G2/G3 cases agreed to treatment with clindamycin (450 mg/d, days 1-10; 300 mg/d, days 11-20) plus isotretinoin (20 mg/d, days 11-20) after being informed of the experimental nature of the combination.. In 6 of 7 (86%) patients, the rash resolved (G1/G0) without dose reduction; in the other patient (G3), the erlotinib dose also had to be reduced. Median time to resolution was 14 days (range 7-20 days). No rash-treatment adverse events occurred during 20 days of administration.. Isotretinoin plus clindamycin promises to be the first effective treatment for erlotinib rash and is being tested further.

Topics: Anti-Bacterial Agents; Carcinoma, Non-Small-Cell Lung; Clindamycin; Dermatologic Agents; ErbB Receptors; Erlotinib Hydrochloride; Exanthema; Humans; Isotretinoin; Lung Neoplasms; Protein Kinase Inhibitors; Quinazolines; Survival Rate; Treatment Outcome

Disseminated and recurrent infundibular folliculitis, henceforth referred to as D.R.I.F., is a very rare, puritic, follicular, benign disease of unknown etiology seen mostly in black males. It is often self-limited and usually unresponsive to local or systemic treatment. However, vitamin A, either alone or combined with vitamin E, is occasionally effective. We report a case of a patient with D.R.I.F. treated successfully with isotretinoin.

Topics: Administration, Oral; Adult; Biopsy; Exanthema; Exocytosis; Folliculitis; Follow-Up Studies; Humans; Isotretinoin; Keratolytic Agents; Lymphocytes; Male; Pruritus; Recurrence; Vitamin A; Vitamin E