isotretinoin and Hyperpigmentation

Skin disorders associated with photodamage from ultraviolet light include wrinkles, hyperpigmentation, tactile roughness, and telangiectasia, and are more common in people with white compared with other skin types. Wrinkles are also associated with aging, hormonal status, smoking, and intercurrent disease.. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to prevent and treat skin wrinkles? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).. We found 20 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.. In this systematic review we present information relating to the effectiveness and safety of the following interventions: carbon dioxide laser, chemical peel, dermabrasion, facelifts, glycolic acid, isotretinoin, lactic acid, natural cartilage polysaccharides (oral or topical), retinyl esters, sunscreens, tazarotene, tretinoin, variable pulse erbium:YAG laser, and vitamin C or E (topical).

Topics: Administration, Oral; Humans; Hyperpigmentation; Isotretinoin; Rhytidoplasty; Skin Aging; Tretinoin

Kyrle's disease (KD) is a primary perforating dermatosis that affects more commonly 30-50 year old females, and clinically characterized by pruritic hyperkeratotic and ulcerated nodules, papules and plaques, localized on extensor surface of upper and lower limbs, and on the trunk.. To determine the effectiveness of the treatment with oral isotretinoin in KD.. We present the case of a 63-year-old woman with hyperkeratotic, erythematous-brown nodules and plaques localized on arms and legs, intensely itching; some lesions were ulcerated and discharging. Histology showed hyperplastic epidermis, cup-shaped invagination, degenerative basophilic material with plug formation. In the upper dermis, there was a dense lympho-histiocytic infiltrate. Narrow-band UVB and low dose oral corticosteroids were ineffective. Treatment with isotretinoin 20 mg/day was started with an excellent response in two months, and complete remission in the next four months. Isotretinoin was reduced to 10 mg/day for additional four months. In the next 9-month follow up, no recurrence of the disease was observed.. Low-dose isotretinoin was very effective and well tolerated in our patient. One previous case treated with isotretinoin has been published.

Topics: Administration, Oral; Darier Disease; Dermatologic Agents; Female; Humans; Hyperpigmentation; Isotretinoin; Middle Aged; Pruritus; Remission Induction; Skin

Topics: Chronic Disease; Dose-Response Relationship, Drug; Drug Administration Schedule; Erythema; Facial Dermatoses; Follow-Up Studies; Humans; Hyperpigmentation; Immunohistochemistry; Isotretinoin; Male; Middle Aged; Recurrence; Retreatment; Severity of Illness Index; Time Factors; Treatment Outcome

Lichen planus pigmentosus (LPP) is a cosmetically distressing pigmentary disorder often posing a therapeutic challenge. Isotretinoin has been shown to be effective in oral and cutaneous LP, but its role in LPP is yet unknown.. To evaluate the efficacy and safety of isotretinoin in the management of LPP.. In this prospective study, 32 clinically and histologically proven patients with LPP were recruited. Subjects were treated with fixed low-dose (20 mg/day) oral isotretinoin once daily for 6 months along with topical sunscreens. Response was graded as mild (<25%), moderate (26-50%), and good (>50%) improvement based on decrease in intensity and progression of hyperpigmentation.. Twenty-seven patients (17 females and 10 males), aged 20-62 years, completed the study. Twenty-three (85.2%) patients had active disease and pruritus at presentation. Treatment outcome was moderate improvement in 15 patients (55.7%) followed by good in seven (21.8%) and mild in two (6.2%). Pruritus subsided at the earliest at 9-14 days, and disease stabilized by 4-6 weeks in treatment-responsive patients. Patients with a shorter duration (≤5 years) of disease and limited body area involvement had a better outcome.. Low-dose isotretinoin seems to be a promising treatment modality in stabilizing and decreasing the pigmentation in LPP particularly in early and limited disease.

Topics: Adult; Body Surface Area; Dermatologic Agents; Female; Humans; Hyperpigmentation; Isotretinoin; Lichen Planus; Male; Middle Aged; Pilot Projects; Prospective Studies; Pruritus; Time Factors; Treatment Outcome; Young Adult

The application of systemic isotretinoin in the treatment of cutaneous photoaging has been well investigated. In addition, well-recognized topical antiaging therapies such as superficial chemical peeling (CP) with α-hydroxy acids have been shown to be more helpful when combined with low-dose oral isotretinoin. Even though the combination of systemic isotretinoin and medium to deep CP has been associated with serious side effects such as delayed wound healing and enlarged incidence of scarring, to date superficial CP and concomitant systemic isotretinoin have been considered safe.. In this report, we present the case of a patient receiving low-dose oral isotretinoin therapy who developed severe painful erythema and erosions that led to permanent hyperpigmentation and scarring of her face and neck after undergoing superficial CP with glycolic acid.. There is a potential risk of hyperpigmentation and scarring with the use of a combination of low-dose oral isotretinoin and glycolic acid peeling.

Topics: Administration, Oral; Adult; Cicatrix; Drug Therapy, Combination; Female; Glycolates; Humans; Hyperpigmentation; Isotretinoin

Although disfiguring hyperpigmentation is a well-defined complication of minocycline therapy, modalities to reverse the phenomenon are unpredictable. We report a case of minocycline-induced, blue-black pigmentation in a 23-year-old Hispanic man, which resolved after treatment with oral isotretinoin for acne vulgaris.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Dermatologic Agents; Humans; Hyperpigmentation; Isotretinoin; Male; Minocycline; Skin

Prurigo pigmentosa (PP) is an uncommon inflammatory disease with pruritic reddish papules, papulovesicules or vesicules that are symmetrically localized on the trunk and nape, accompanied by reticular hyperpigmentation. Currently available therapeutic options seem somewhat unsatisfying. Herein, we report an 18-year-old female with PP successfully treated with low-dose isotretinoin.. The patient presented with a symmetrical pruritic eruption on the lateral sides of her trunk with erythematous papules on a hyperpigmented background. Based on the typical clinical and associated histological findings, the patient was diagnosed as PP and a treatment with low-dose isotretinoin 0.3 mg/kg/day (20 mg/day) was started.. After a total of 3 months of 20 mg/day isotretinoin therapy, all erythematous macules and papules resolved and the residual pigmentation had almost disappeared.. Low-dose isotretinoin is not only adequate for the improvement of erythematous lesions, it also helps resolve the reticular hyperpigmentation of PP. Further studies are needed to observe the efficacy of isotretinoin in the treatment of PP.

Topics: Adolescent; Dermatologic Agents; Female; Follow-Up Studies; Humans; Hyperpigmentation; Isotretinoin; Prurigo; Treatment Outcome

Topics: Acne Vulgaris; Administration, Oral; Adult; Asian People; Female; Humans; Hyperpigmentation; Isotretinoin; Keratolytic Agents