isotretinoin and Lip-Diseases

It is generally accepted that the inhibition of sebum excretion has a predictive value for anti-acne activity. Whereas oral 13-cisretinoic acid (13-cis-RA) decreases sebum excretion, it has not been shown so far if oral all-trans-retinoic acid (tretinoin, tRA) does so. The aim of this exploratory study was to investigate the effect of oral tRA on the sebum excretion rate (SER) in young male subjects.. 12 healthy volunteers with a baseline SER above 1.0 microgram/cm2/min were treated with 20 mg/day tRA for 4 weeks. The SER was measured at weeks 2 and 4. Adverse reactions were recorded.. The mean SER varied from 1.56 at baseline to 1.65 at week 2 and to 1.49 micrograms/cm2/min at week 4. Comparison with values obtained in the same subjects previously treated with either 13-cis-RA or 9-cis-retinoic acid indicated that tRA less sebosuppressive. Mucocutaneous reactions and headache were the most frequent side effects of oral tRA.. The lack of effect on the SER suggests that oral tRA would probably be ineffective against acne. The fact that, of the three isomers tested, only 13-cis-RA (which does not bind to nuclear receptors) shows activity may suggest that sebosuppression is not nuclear receptor mediated. We discuss other hypotheses related to pharmacokinetics.

Topics: Acne Vulgaris; Administration, Oral; Adult; Alitretinoin; Drug Eruptions; Facial Dermatoses; Headache; Humans; Isotretinoin; Keratolytic Agents; Lip Diseases; Male; Mucous Membrane; Retinoids; Sebum; Skin; Tretinoin

Topics: Acne Vulgaris; Adolescent; Dermatologic Agents; Emollients; Female; Humans; Isotretinoin; Lip Diseases; Petrolatum

Topics: Acne Vulgaris; Acute-Phase Proteins; Adult; Choristoma; Dermatologic Agents; Humans; Isotretinoin; Lip Diseases; Lipocalin-2; Lipocalins; Male; Proto-Oncogene Proteins; Sebaceous Glands; Up-Regulation

Isotretinoin is frequently prescribed for the treatment of acne vulgaris. Among the numerous documented adverse effects, most common are xerostomia and cheilitis. Lip abscesses as a consequence of cheilitis present dramatically and may pose a diagnostic challenge.. We present a case of a 15-year-old boy with a severe lip abscess requiring incision and drainage and hospital admission for intravenous antibiotic treatment of methicillin-resistant Staphylococcus aureus. We discuss the pathophysiologic characteristics of isotretinoin therapy and the likely causative role that the medication played in the development of the lip abscess.. Although rare, lip abscesses related to isotretinoin therapy present with substantial morbidity and should be promptly recognized. Misdiagnosis of mucositis and angioedema may delay appropriate therapy.

Topics: Abscess; Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Dermatologic Agents; Drainage; Hospitalization; Humans; Isotretinoin; Lip Diseases; Male; Methicillin-Resistant Staphylococcus aureus; Staphylococcal Infections

Severe scarring acne is frequently treated with isotretinoin. Patients treated with this drug may expect some of the more common complications including mucositis. Less common complications may also occur in a small number of patients. While undergoing treatment, patients may become colonized with Staphylococcus bacteria. However, the incidence of perioral abscess formation in patients taking isotretinoin is not commonly reported and the onset of this adverse event may masquerade as angioedema or severe mucositis.This article presents a case of a significant perioral abscess and discuss the need for prompt recognition as well as treatment of the infection.The case reported is unique due to the extent and severity of the abscess.

Topics: Abscess; Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Cicatrix; Dermatologic Agents; Humans; Isotretinoin; Lip Diseases; Male; Methicillin-Resistant Staphylococcus aureus; Severity of Illness Index; Staphylococcal Infections

Topics: Acne Vulgaris; Adult; Female; Humans; Isotretinoin; Lip Diseases

Topics: Adult; Fox-Fordyce Disease; Humans; Isotretinoin; Lip Diseases; Male