tretinoin and Xerostomia

Thirty patients with treatment-resistant cystic and conglobulate acne entered a randomized double-blind protocol, testing the efficacy of isotretinoin versus tetracycline. After 16 weeks of isotretinoin treatment, the mean number of cysts decreased by 64% and the mean sum of the longest diameters was reduced by 68%. After 16 weeks of tetracycline therapy, the total number of cysts showed a mean decrease of 52%, and the mean sum of the longest diameters decreased by 60%. The reduction in the number of cysts and the sum of their longest diameters that occurred after 16 weeks of treatment was statistically significant for each of the treatment groups, but there was no statistically significant difference between the treatment groups at the end of therapy. Eight weeks after the discontinuation of treatment in the isotretinoin group, there was an overall reduction from baseline of 82% in the cyst count and 88% in the sum of the longest diameters. In the tetracycline treatment group, the overall reduction from baseline in the cyst count was 54% and in the sum of the longest diameters, 60%. This led to a statistically significant difference in the two treatment groups at 24 weeks. All patients on isotretinoin experienced side effects that were primarily related to the integumentary system but necessitated discontinuation of the drug for a short period of time in only one patient. Long-term follow-up, 8 months after discontinuation of the study, showed a prolonged significant remission of acne in the isotretinoin group but not in the tetracycline group.

Topics: Acne Vulgaris; Adolescent; Adult; Cataract; Cheilitis; Clinical Trials as Topic; Double-Blind Method; Epistaxis; Female; Follow-Up Studies; Humans; Isomerism; Isotretinoin; Male; Random Allocation; Tetracycline; Tretinoin; Xerophthalmia; Xerostomia

A follow-up was done on the patients of the German multicenter study with severe conglobate acne who had been treated with different dosages of 13-cis-retinoic acid. Eighty-seven patients were monitored from 12 to 21 months. Optimal long-term therapeutic effects were obtained with an initial dose of 1.0 mg/kg body weight, for 3 months, followed by another 3-month-treatment period with 0.2 mg/kg body weight. Six months after the termination of therapy 96% of the patients were still in remission and 81% after 12 months. Comparative figures for the administration of doses were 84% as opposed to 47% (0.5----0.2 mg/kg body wt.) and 74% as opposed to 37% (0.2----0.2 mg/kg body wt.), respectively. It is suggested from the present data that a high initial dosage of 13-cis-retinoic acid be chosen in order to obtain optimal long-term therapeutic effects. Transiently elevated lipid levels as well as other tolerable side effects return to normal within 3 months at the latest after discontinuation of treatment.

Topics: Acne Vulgaris; Adolescent; Adult; Clinical Trials as Topic; Dermatitis, Seborrheic; Follow-Up Studies; Humans; Isomerism; Isotretinoin; Mucous Membrane; Recurrence; Skin; Time Factors; Tretinoin; Xerostomia

Orally administered retinoids are synthetic derivatives of vitamin A. This new group of drugs (not yet available for general use in the United States) has been effective in experimental trials for treatment of a wide range of skin diseases. The current status of two of these drugs, isotretinoin (13-cis-retinoic acid) and etretinate (Ro 10-9359), is herein reviewed.

Topics: Acne Vulgaris; Administration, Oral; Child; Clinical Trials as Topic; Facial Dermatoses; Female; Humans; Isomerism; Isotretinoin; Keratins; Keratitis; Neoplasms; Psoriasis; Skin Diseases; Tretinoin; Xerostomia

In an open trial, eight patients with psoriasis took part in a four-month study to evaluate the effect of a new oral synthetic retinoid Ro-10-9359 (Tigason). All patients improved on the treatment, although one had side effects severe enough to force dosage reduction with less satisfactory control.

Topics: Administration, Oral; Adult; Aged; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Psoriasis; Time Factors; Tretinoin; Xerostomia

Twenty patients with severe rosacea were treated with isotretinoin for 3-6 months. Six patients initially received 1.0 mg/kg and 14 patients 0.5 mg/kg of isotretinoin. The response was good or excellent in all patients and the papulopustular lesions in particular cleared promptly. Patients receiving 1.0 mg/kg of isotretinoin experienced more side-effects and the dose had to be lowered in five of the six patients. Seventeen of the 20 patients had no relapses during a follow-up of one year showing that isotretinoin has a long-lasting favourable effect in rosacea.

Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Isomerism; Isotretinoin; Male; Middle Aged; Nasal Mucosa; Recurrence; Rosacea; Time Factors; Tretinoin; Xerostomia

Oral retinoids are effective in the treatment of patients with a variety of malignant and nonmalignant skin disorders, including mycosis fungoides. We treated six patients with cutaneous T-cell lymphomas with isotretinoin 1 to 2 mg/kg/d. All patients experienced symptomatic relief (fading of skin lesions and disappearance of pruritus) within two to eight weeks of starting the drug therapy; pretreatment and posttreatment biopsy specimens were unchanged. Adverse effects were minor and primarily consisted of drying of the mucous membranes. We conclude that isotretinoin is a well-tolerated, easily administered drug that provides good palliation of symptoms and signs associated with cutaneous T-cell lymphoma in patients who are unable or unwilling to comply with standard therapy.

Topics: Aged; Female; Humans; Isotretinoin; Lymphoma, Non-Hodgkin; Male; Middle Aged; Skin Neoplasms; T-Lymphocytes; Tretinoin; Xerostomia