Isotretinoin in acne vulgaris: a prospective analysis of 160 cases from Kuwait.(CASE REPORTS)

Abstract

A total of 160 patients (59 male and 101 female) ages varying from 13 to 28 years (mean age 20 years) with moderate to severe acne were treated with isotretinoin in the doses ranging from 0.5 mg/kg/day to 1 mg/kg/day. The drug was given for a period ranging from 6 to 28 weeks. The patients were followed up regularly for a period of 12 months after stoppage of isotretinoin for any evidence of relapse. In the event of a recurrence greater than mild acne after 8 weeks of stoppage of isotretinoin therapy, the patients were given another course of the drug. Patients were considered to be non-relapsing if they had no evidence of recurrence after 12 months of follow-up. Twenty seven patients were excluded from the study. Of the remaining 133 patients (51 male and 82 female) only 117 patients (36 male and 81 female) could follow up for at least 12 months after stopping therapy. Of the 133 patients, a total of 127 patients (95.5%) achieved complete or partial clearance. Forty two percent (total 49 patients: 20 male and 29 female) experienced relapse after stopping therapy. Of these, 21 (42.85%) were given a second course of the drug. None of the patients developed a rise in lipids levels significant enough to warrant stoppage of the drug.

**********

Introduction

Isotretinoin, after being synthesized in 1955, (1) has been studied in Europe since 1971 for acne. In the late 1970s, isotretinoin was confirmed to be highly effective in the treatment of acne vulgaris and cystic conglobate acne. (2) With years of experience this drug has been used to treat less severe and long-standing acne unresponsive to conventional treatments. However, because of its non-availability in many developing nations and high cost, it has not been that widely used in third world countries. Therefore, there is very little data available on the use of isotretinoin in acne vulgaris from developing nations. Isotretinoin is freely available in Kuwait and is supplied to the local population free of cost from all the major government hospitals. Therefore, we had an opportunity to study large number of acne patients treated with isotretinoin. The aim of this study was to identify the most suitable types of acne for isotretinoin therapy; to determine the relationship between age, sex, type, and severity of acne, cumulative dose of isotretinoin and presence of endocrinologic abnormalities to…