isotretinoin and Tachycardia--Supraventricular

Oral isotretinoin is currently the most effective therapy for acne, but is associated with numerous adverse effects. To investigate the cardiac effects of isotretinoin, acne patients receiving isotretinoin for 6 months were studied. Methods Twenty-six patients with acne vulgaris were enrolled in the study. The patients were treated with a dose of 0.8 mg/kg/day of isotretinoin (Roaccutane, Hoffman-La Roche, Basle, Switzerland) for 6 months. All participants were assessed pretreatment and at the third month of therapy with 24-h Holter monitoring of electrocardiography. Results Twenty-two patients completed the study (19 females and three males). Initial 24-h Holter monitoring showed normal sinus rhythm in all patients, with a mean heart rate of 79 beats/min (lowest, 63 beats/min; highest, 97 beats/min). At the third month of therapy, 24-h Holter monitoring showed normal sinus rhythm in all patients, with a mean heart rate of 81 beats/min (lowest, 67 beats/min; highest, 91 beats/min). All patients were in sinus rhythm throughout the recording period. None of the patients had supraventricular tachycardia or atrial arrhythmia. Conclusion In this study, 6 months of isotretinoin therapy significantly improved acne and did not cause any cardiac adverse effects at a dose of 0.8 mg/kg/day.

Topics: Acne Vulgaris; Adult; Arrhythmia, Sinus; Dermatologic Agents; Electrocardiography, Ambulatory; Female; Humans; Isotretinoin; Male; Tachycardia, Supraventricular

We describe a 16-year-old boy who presented with palpitations for 1 week while being on isotretinoin treatment for nodulocystic facial acne for 3 months. Twenty four-hour Holter monitoring showed frequent premature atrial beats and episodes of nonsustained atrial tachycardia. He never had any episodes of palpitations previously. His complaints almost disappeared within a week after stopping the treatment. He remained asymptomatic since the discontinuation of the drug. The temporal relationship between isotretinoin treatment and patient's symptoms in the presence of documented arrhythmia suggests a drug-related cause. As a result, clinicians should be aware of the possible arrhythmogenic effect of isotretinoin.

Topics: Acne Vulgaris; Adolescent; Diagnosis, Differential; Electrocardiography; Humans; Isotretinoin; Male; Tachycardia, Supraventricular