MedWorm: Accutane

Acitretin/isotretinoin: Angioedema (first report with acitretin): 2 case reports

Reactions — Thu, 02 Feb 2012 18:34:27 +0100

(Source: Reactions)

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Isotretinoin associated with risk of suicide. - Ramió Montero E, Iglesias Sancho MI, Eguileor Partearroyo B.

SafetyLit: All (Unduplicated) — Mon, 30 Jan 2012 15:32:08 +0100

[Abstract unavailable] Language: Spa... (Source: SafetyLit: All (Unduplicated))

Oral isotretinoin and pregnancy prevention programmes: reply from authors

British Journal of Dermatology — Mon, 23 Jan 2012 17:26:52 +0100

(Source: British Journal of Dermatology)

MYORISAN (Isotretinoin) Capsule, Liquid Filled [VersaPharm Incorporated]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Mon, 23 Jan 2012 05:00:00 +0100

Updated Date: Jan 23, 2012 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Isotretinoin associated with risk of suicide.

Farmacia Hospitalaria — Fri, 20 Jan 2012 05:00:00 +0100

Authors: Ramió Montero E, Iglesias Sancho MI, Eguileor Partearroyo B PMID: 22266200 [PubMed - as supplied by publisher] (Source: Farmacia Hospitalaria)

Effects of isotretinoin treatment on general psychiatric symptoms, quality of life and social phobia in acne vulgaris patients

Journal of the European Academy of Dermatology and Venereology — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Journal of the European Academy of Dermatology and Venereology)

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AMNESTEEM (Isotretinoin) Capsule [Physicians Total Care, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Mon, 09 Jan 2012 05:00:00 +0100

Updated Date: Jan 9, 2012 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Prescriptive contraceptive use among isotretinoin users in the Netherlands in comparison with non‐users: a drug utilisation study

Pharmacoepidemiology and Drug Safety — Sun, 01 Jan 2012 05:00:00 +0100

ConclusionCompliance with the contraceptive use according to a PPP for a teratogenic drug such as isotretinoin is 52%–64%, which is lower than anticipated. Reasons for the low compliance will need to be clarified before further measures can be taken. Copyright © 2012 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)

The effects of systemic isotretinoin and antibiotic therapy on the microbial floras in patients with acne vulgaris

Journal of the European Academy of Dermatology and Venereology — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions Systemic isotretinoin and antibiotic treatments in acne patients precisely caused variations in the microbial floras of several sites of the body, while isotretinoin was commonly more responsible than antibiotics. Knowing that alterations in the microbial colonization of the flora regions may preceede infectious disease and bacterial resistance, treatment options and follow‐up procedures in acne vulgaris should be carefully determined to reduce the risk of destruction of the microbial flora. (Source: Journal of the European Academy of Dermatology and Venereology)

FDA Advisers: iPLEDGE Needs More Tweaking: Currently, there are about 20,000 calls a month to iPLEDGE call centers, a decline in volume.

Ob.Gyn. News — Sun, 01 Jan 2012 05:00:00 +0100

SILVER SPRING, MD.–The iPLEDGE risk management program for isotretinoin has reduced fetal exposure to the teratogen but still needs to be tweaked to reduce burdens on physicians and improve patient access, advisers to the Food and Drug Administration said. (Source: Ob.Gyn. News)

Sacroiliitis secondary to isotretinoin

Australasian Journal of Dermatology — Thu, 29 Dec 2011 05:00:00 +0100

ABSTRACTReported is the case of a 17‐year old male with sacroiliitis confirmed by magnetic resonance imaging (MRI) while undergoing isotretinoin treatment for acne vulgaris. The cessation of isotretinoin and symptomatic treatment resolved the symptoms within 6 weeks, with no signs of sacroiliitis on repeat MRI 10 months later. The temporal association of disease onset and commencement of isotretinoin along with rapid recovery on withdrawal supports the role of isotretinoin in this case. (Source: Australasian Journal of Dermatology)

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Blood donors on teratogenic drugs and donor deferral periods in a clinical situation

Vox Sanguinis — Wed, 28 Dec 2011 05:00:00 +0100

Deferral of blood donors taking teratogenic drugs is critical. From March 2008 to January 2009, we analysed stored blood specimens from donors who had taken teratogenic drugs and whose blood was transfused to women of childbearing age to determine the plasma concentration at the time of donation using high‐performance liquid chromatography. In total, 167 specimens were examined. The numbers of specimens exceeding the quantification limit were 7, 39, 4, 2 and 1 for finasteride, isotretinoin, acitretin, etretinate and dutasteride, respectively. Finasteride was beyond the recommended drug deferral period in one specimen. These results may help create practical deferral policies. (Source: Vox Sanguinis)

Influence of isotretinoin on hippocampal-based learning in human subjects

Psychopharmacology — Fri, 23 Dec 2011 06:49:10 +0100

Conclusion Isotretinoin does not reduce learning and memory and our study suggests that it may instead lead to a dose-related improvement in specific aspects of hippocampal learning and memory. Retinoic acid functions in the hippocampus as the active metabolite of vitamin A, suggesting that this may be a limiting factor in the human hippocampus and addition of exogenous retinoic acid brings levels closer to an optimal state. Content Type Journal ArticleCategory Original InvestigationPages 1-8DOI 10.1007/s00213-011-2611-yAuthors Anthony D. Ormerod, Division of Applied Medicine, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZN UKChamandeep K. Thind, Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, UKShantini A. Rice, Departmen...

Implementation of the Harmonized EU Isotretinoin Pregnancy Prevention Programme: A Questionnaire Survey among European Regulatory Agencies

Drug Safety — Fri, 16 Dec 2011 06:55:15 +0100

(Source: Drug Safety)

Isotretinoin/tretinoin: Xerostomia: case report

Reactions — Thu, 01 Dec 2011 07:29:01 +0100

(Source: Reactions)

Inflammatory back pain in patients treated with isotretinoin.

J Rheumatol — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Pehlivan Y, Kisacik B, Sayiner ZA, Onat AM PMID: 22134798 [PubMed - in process] (Source: J Rheumatol)

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[What's new in dermatological therapy?].

Annales de Dermatologie et de Cenereologie — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Dupuy A Abstract Several good-quality randomised trials brought useful information on how to manage severe skin infections and develop anti-staphylococcus strategies. Trials on common warts did not bring any valuable solution. Rituximab and omalizumab have seen their indications becoming more precise or broadened. Meta-analyses have been particularly numerous, but most of the time with no decisive conclusion, since this methodology presents strong limitations for studying safety data. Most important work has been rather directed toward analysing safety data rather than efficacy. Among the most important results, are those from a retrospective cohort of patients taking isotretinoin: suicidal risk has to be linked to severe acne itself, rather than to the drug. PMID: 222...

Hypoacusia in a Patient Treated by Isotretinoin

Clinical and Developmental Immunology — Thu, 24 Nov 2011 23:55:40 +0100

We report one case of hypoacusia and tinnitus in a 15-year-old boy treated with isotretinoin during 6 weeks, who quickly improved after isotretinoin withdrawal. Also, we comment other publications about hearing alterations in patients treated with isotretinoin and other retinoids. (Source: Clinical and Developmental Immunology)

Large Benign Condyloma Acuminatum: Successful Treatment with Isotretinoin and Interferon Alpha.

Acta Derm Venereol A... — Thu, 24 Nov 2011 05:00:00 +0100

Authors: Pasmatzi E, Kapranos N, Monastirli A, Melachrinou M, Georgiou S, Tsambaos D PMID: 22113200 [PubMed - as supplied by publisher] (Source: Acta Derm Venereol A...)

Effect of isotretinoin treatment on plasma holotranscobalamin, vitamin B12, folic acid, and homocysteine levels: non‐controlled study

International Journal of Dermatology — Tue, 22 Nov 2011 05:53:05 +0100

AbstractIsotretinoin (Iso) has been used for the treatment of acne. Some previous studies reported elevated homocysteine (Hcy) levels after treatment with Iso. Some side effects have clinical presentations similar to vitamin B12, folic acid deficiencies, and hyperhomocysteinemia. In the present study we evaluated the plasma Hcy levels, the vitamins involved in its metabolism (vitamin B12 and folic acid), and holotranscobalamin (HoloTC), a transport system for vitamin B12 absorption in patients receiving Iso treatment for acne vulgaris. A total of 66 patients with acne vulgaris between the ages of 18 and 40 years were included. Screening for hemoglobin, creatinine, SGOT, SGPT, total cholesterol, triglycerides, high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cho...

The new therapy schema of the various kinds of acne based on the mucosa-skin side effects of the retinoids.

Cutaneous and Ocular Toxicology — Mon, 21 Nov 2011 05:00:00 +0100

Authors: Bergler-Czop B, Brzezińska-Wcisło L Abstract The most common adverse effects of oral isotretinoin (>1/10) are: cheilitis, skin dryness, erythema, itching, scaling, bruising, skin atopy, conjunctivitis, dry eyes and eyelid inflammation. The aim of this work was to define an optimal dose regime of the oral isotretinoin allowing for effective reduction of sebum production and minimalization of adverse effects such as decreased skin moisturization, increase in TEWL and intensified erythema. The skin parameters were assessed using the MPA 5 diagnostic apparatus. Moisturization together with an increase in TEWL and erythema during treatment with isotretinoin seem to be crucial factors responsible for patient discomfort. The decrease in the pigment content in the skin during...

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What’s new in acne? An analysis of systematic reviews and clinically significant trials published in 2010–11

Clinical And Experimental Dermatology — Sat, 19 Nov 2011 22:24:25 +0100

SummaryThis review summarizes important clinical developments in acne treatment identified in five systematic reviews and two significant primary research studies, published between March 2010 and February 2011. Although evidence showing a direct link between development of bacterial resistance and oral antibiotic therapy for acne is not convincing, prescribers can still tailor their practice to minimize future risks by stopping treatment when appropriate, using benzoyl peroxide, and avoiding combining topical and systemic antimicrobials. A systematic review evaluating combination products containing benzoyl peroxide did not show convincing evidence that such products are superior to monotherapies. A systematic review of combined oral contraceptives confirmed their efficacy for acne in wom...

Oral isotretinoin for acne

NeLM - Drug Specific Reviews — Fri, 18 Nov 2011 05:00:00 +0100

The objectives are as follows: To assess the efficacy and safety of oral isotretinoin for acne vulgaris. (Source: NeLM - Drug Specific Reviews)

Isotretinoin: Rhabdomyolysis: case report

Reactions — Thu, 10 Nov 2011 08:03:53 +0100

(Source: Reactions)

Memory disorders associated with consumption of drugs: updating through a case/noncase study in the French PharmacoVigilance Database

British Journal of Clinical Pharmacology — Thu, 10 Nov 2011 07:45:51 +0100

CONCLUSIONS Our study confirmed an association between memory disorders and some drugs, such as benzodiazepines and anticonvulsants. However, other drugs, such as benzodiazepine‐like hypnotics, newer anticonvulsants, serotonin reuptake inhibitor antidepressants, isotretinoin and ciclosporin were significantly associated with memory disorders, although this was not described or poorly described in the literature.Taking account of the limits of this study in the FPVD (under‐reporting, notoriety bias etc.), the case/noncase method allows assessment and detection of associations between exposure to drugs and a specific adverse drug reaction, such as memory disorders, and could thus generate signals and orientate us to further prospective studies to confirm such associations. (Source: Briti...

Disabling Acne Fulminans

Anais Brasileiros de Dermatologia — Thu, 10 Nov 2011 07:13:02 +0100

Acne fulminans é uma manifestação rara, que pode ocorrer durante a evolução da acne vulgar, principalmente, em adolescentes masculinos. Uso de isotretinoína, testosterona, e reações imunológicas exacerbadas no organismo são desencadeantes relacionados. Sinais, sintomas e alterações laboratoriais como: febre, hepatomegalia, poliartralgia, leucocitose, plaquetose, aumento de provas inflamatórias e transaminases, são característicos. A cintilografia óssea pode detectar lesões líticas em vários sítios do esqueleto. O tratamento é realizado com prednisolona, isotretinoína e antibióticos se infecções secundárias. Este caso relata um paciente masculino com diagnóstico de acne grau III, que desenvolveu acne fulminans e sacroileíte bilateral, com incapacidade de deambula...

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Angiodema due to oral acitretin and isotretinoin

Anais Brasileiros de Dermatologia — Thu, 10 Nov 2011 07:13:02 +0100

We report two uncommon cases of palpebral and labial angiodema due to retinoids, by acitretin and oral isotretinoin respectively: a 48-year-old man with psoriasis and a 24-year-old woman with severe acne resistant to antibiotics and topical drugs. In both cases the reaction persisted through-out treatment with these drugs, but resolved quickly after discontinuation. Reintroduction of the drugs brought on angioedema againAngioedema pode ser causado por diversos fármacos como : antiinflamatórios não-esteroidais, inibidores da ECA, contrastes, antibióticos e frutos do mar, entre outras causas. Pode ser uma reação alérgica, mediada por IgE, ou não-alérgica, com apresentações clínicas semelhantes. Angioedema por isotretinoína já foi relatado, mas não por acitretina. Relatamos doi...

The independent association of serum retinol and β‐carotene levels with hyperuricemia– A national population study

Arthritis Care and Research — Thu, 10 Nov 2011 05:00:00 +0100

ConclusionsThese nationally representative data raise concerns that vitamin A supplementation and food fortification may contribute to the high frequency of hyperuricemia in the US population, whereas β‐carotene intake may be beneficial against hyperuricemia. The use of β‐carotene as a novel preventive treatment for gout deserves further investigation. © 2011 by the American College of Rheumatology (Source: Arthritis Care and Research)

Terminal Hematuria Associated with Oral Isotretinoin Treatment in a Patient with Acne Vulgaris

Pediatric Dermatology — Tue, 08 Nov 2011 05:00:00 +0100

Abstract: Hematuria is defined as the abnormal presence of red blood cells in the urine and is commonly divided into gross and microscopic hematuria. Terminal hematuria occurs at the end of the urine stream and may have a prostatic, bladder, or trigonal cause. Here, we present a 16‐year‐old boy who developed terminal hematuria after 1 month of treatment with isotretinoin for acne vulgaris. This side effect of isotretinoin is not reported in the literature. This is the first case report. (Source: Pediatric Dermatology)

SAPHO Syndrome Associated With Hidradenitis Suppurativa Successfully Treated with Infiximab and Methotrexate.

Bulletin of the NYU Hospital for Joint Diseases — Thu, 03 Nov 2011 21:35:02 +0100

Authors: De Souza A, Solomon GE, Strober BE Abstract SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) is a rare chronic infammatory musculoskeletal disorder of unknown etiology observed in children and young adults, which involves both osteo-articular infammation and skin abnormalities. We review the case of a 22-year-old male, who presented with a 5-year history of hidradenitis suppurativa (HS), acne vulgaris, joint stiffness, and pain. Previous ineffective treatments included isotretinoin and oral antibiotics. Marked improvement of all cutaneous features was noticed after the frst dose of infliximab and methotrexate; continued treatment resulted in the complete remission of the arthritis and enthesopathy. This case report demonstrates the effcacy and safet...

[Multiple cutaneous osteomas of the face in a setting of chronic acne].

Annales de Dermatologie et de Cenereologie — Tue, 01 Nov 2011 04:00:00 +0100

We report a case concerning a 35-year-old woman. PATIENTS AND METHODS: A 35-year-old woman had been treated for acne since the age of 22 years, as part of which she received two courses of oral isotretinoin. We noted the secondary appearance of several microcysts on the face for which the excision was very difficult. Curiously, these small formations did not contain keratin but were very callous. Histological examination revealed foci of osseous metaplasia, probably of postinflammatory origin. Treatment consisted solely of excision of the lesions. DISCUSSION: Osteoma cutis comprises two distinct groups (primary and secondary). In our case, there were multiple cutaneous osteomas of the face resulting from chronic acne. The differential diagnosis was idiopathic miliary osteomatosis...

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Isotretinoin: Epistaxis and dryness in the ocular and buccal mucosae: case report

Reactions — Wed, 26 Oct 2011 13:05:18 +0100

(Source: Reactions)

Isotretinoin: Worsening of myopia: case report

Reactions — Wed, 26 Oct 2011 13:05:18 +0100

(Source: Reactions)

Isotretinoin systemic therapy and the shadow cast upon dermatology's downtrodden hero

Clinics in Dermatology — Sat, 22 Oct 2011 04:59:17 +0100

Abstract: Isotretinoin has revolutionized the field of dermatology, offering a cure for severe acne vulgaris and a therapeutic option for a variety of other chronic diseases and cancers. This drug has done more for many diseases in medicine than many drug classes have done for a single disorder, and yet, its use and availability have been threatened in the United States. Federal restrictions in the form of the IPLEDGE teratogenicity prevention plan have made the use of this drug more complex. Millions of dollars in litigation and claims of injury have fueled hysteria among laymen about the use of this drug. Overwhelmed with worries of its potential adverse effects, the public forgets that withholding isotretinoin therapy is not without its own risks. Isoteretinoin therapy can prevent lifel...

Oral isotretinoin in different dose regimens for acne vulgaris: A randomized comparative trial

Indian Journal of Dermatology, Venereology and Leprology — Fri, 21 Oct 2011 04:00:00 +0100

Conclusion: We conclude that for severe acne either conventional high doses of isotretinoin may be used or we can give conventional high dose for initial eight weeks and later maintain on low doses. Use of isotretinoin should be considered in mild to moderate acne also, in low doses; 20 mg, alternate day seems to be an effective and safe treatment option in such cases. (Source: Indian Journal of Dermatology, Venereology and Leprology)

Ciclosporin: Sebaceous hyperplasia treated with isotretinoin: 2 case reports

Reactions — Wed, 12 Oct 2011 06:03:59 +0100

(Source: Reactions)

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Oral isotretinoin and pregnancy prevention programs: reply from authors

British Journal of Dermatology — Mon, 10 Oct 2011 04:00:00 +0100

(Source: British Journal of Dermatology)

Oral Isotretinoin and Pregnancy Prevention Programs

British Journal of Dermatology — Mon, 10 Oct 2011 04:00:00 +0100

(Source: British Journal of Dermatology)

Oral isotretinoin and pregnancy prevention programs: reply from authors.

The British Journal of Dermatology — Mon, 10 Oct 2011 04:00:00 +0100

Authors: Crijns HJ, Straus SM, de Jong-van den Berg LT PMID: 21985080 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)

Oral Isotretinoin and Pregnancy Prevention Programs.

The British Journal of Dermatology — Mon, 10 Oct 2011 04:00:00 +0100

Authors: Thiboutot D, Gollnick H, Bettoli V, Dreno B, Kang S, Leyden JJ, Shalita A, Torres V, PMID: 21985025 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)

Oral isotretinoin and pregnancy prevention programmes

British Journal of Dermatology — Mon, 10 Oct 2011 04:00:00 +0100

(Source: British Journal of Dermatology)

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Adult women with acne have a higher risk of elevated triglyceride levels with the use of oral isotretinoin

Anais Brasileiros de Dermatologia — Sun, 09 Oct 2011 05:29:10 +0100

A isotretinoína apresenta restrições relacionadas a efeitos no perfil lipídico. Revisaram-se 90 pacientes tratados, em busca de fatores predisponentes a essas alterações. Houve elevação significativa do colesterol e triglicerídeos. Os pacientes em que estes últimos mostraram essa alteração foram, em sua maioria, do sexo feminino, predileção que não ocorria com as alterações iniciais. Mulheres com acne persistente talvez representem população de risco para tais efeitos colateraisThere are restrictions associated with the use of isotretinoin because of its effects on the lipid profile. The records of ninety patients treated with this medication were reviewed to identify factors that would predispose patients to these abnormalities. A significant increase in cholesterol and...

Safe and Successful Treatment of Acne Vulgaris with Isotretinoin in a Patient with Chronic Granulomatous Disease

Pediatric Dermatology — Tue, 04 Oct 2011 04:00:00 +0100

We report the fourth published case of acne vulgaris treated with isotretinoin in an individual with CGD, with a safe and successful outcome. (Source: Pediatric Dermatology)

Improbable research: chicken bone injury leaves a fowl smell

Guardian Unlimited Science — Mon, 03 Oct 2011 15:29:00 +0100

Baffling medical mystery of the poultry worker who stank for five yearsFour doctors in Wales rose to fame because of a man who pricked his finger and smelled putrid for five years.The doctors were hit nose-on with one of the most baffling medical mysteries on record. It all started with a chicken. The case ended happily – yet mysteriously – half a decade later, the stink having vanished. The Lancet published an account of this called, accurately, A Man Who Pricked His Finger and Smelled Putrid for 5 Years.The report, written by the relieved but puzzled physicians, ends with a plea: "We ask assistance from colleagues who may have encountered a similar case or for suggestions to relieve this patient's odour."Here's what happened. In September 1991, a 29-year-old man who dressed chickens ...

Rosacea Treatment with Intermediate-dose Isotretinoin: Follow-up with Erythema and Sebum Measurements.

Acta Dermato-Venereologica — Wed, 28 Sep 2011 04:00:00 +0100

In conclusion, 20 mg/day isotretinoin was rapidly efficient for reducing both inflammatory lesions and erythema in rosacea. PMID: 21952746 [PubMed - as supplied by publisher] (Source: Acta Dermato-Venereologica)

CLARAVIS (Isotretinoin) Capsule [Physicians Total Care, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 27 Sep 2011 05:00:00 +0100

Updated Date: Sep 27, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Diffuse idiopathic skeletal hyperostosis associated with bexarotene

Journal of the American Academy of Dermatology — Sun, 18 Sep 2011 01:35:53 +0100

We present a case of DISH associated with bexarotene to increase awareness of this potential complication. (Source: Journal of the American Academy of Dermatology)

Cochrane Review: Minocycline for acne vulgaris: efficacy and safety

Evidence-Based Child Health: A Cochrane Review Journal — Thu, 01 Sep 2011 04:00:00 +0100

AbstractBackgroundMinocycline is a tetracycline antibiotic that is commonly used in the treatment of moderate to severe acne vulgaris. Although it is more convenient for patients to take than first‐generation tetracyclines, as it only needs to be taken once or twice a day and can be taken with food, it is more expensive. Concerns have also been expressed over its safety following the deaths of two patients taking the drug. There is a lack of consensus among dermatologists over the relative risks and benefits of minocycline. As most acne prescribing is undertaken by general practitioners, it is important that guidelines issued to them are based on the best available evidence rather than personal judgements.ObjectivesTo collate and evaluate the evidence on the clinical efficacy of minocycl...

Association between isotretinoin and mood changes: Myth or reality? An updated overview

International Journal of Dermatology — Thu, 01 Sep 2011 04:00:00 +0100

(Source: International Journal of Dermatology)

Risk of IBD in Isotretinoin Users Appears ‘Very Small’

Rheumatology News — Thu, 01 Sep 2011 04:00:00 +0100

Although no link between isotretinoin therapy and inflammatory bowel disease has been proven, the absolute risk for these disorders in conjunction with treatment appears small. (Source: Rheumatology News)

[Treatment of rosacea].

Annales de Dermatologie et de Cenereologie — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Parodi A, Drago F, Paolino S, Cozzani E, Gallo R Abstract A range of treatment options are available in rosacea, which include several topical (mainly metronidazole, azelaic acid, other antibiotics, sulfur, retinoids) and oral drugs (mainly tetracyclines, metronidazole, macrolides). In some cases, the first choice is a systemic therapy because patients may have sensitive skin and topical medications can be irritant. Isotretinoin can be used in resistant cases of rosacea. Unfortunately, the majority of studies on rosacea treatments are at high or unclear risk of bias. A recent Cochrane review found that only topical metronidazole, azelaic acid, and oral doxycycline (40mg) had some evidence to support their effectiveness in moderate to severe rosacea and concluded that furth...

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Widened access to isotretinoin raises concern over teratogenicity

Reactions — Sat, 27 Aug 2011 15:26:04 +0100

(Source: Reactions)

Corticosteroids/isotretinoin/temozolomide: First report of progressive multifocal leukoencephalopathy: case report

Reactions — Sat, 27 Aug 2011 15:26:04 +0100

(Source: Reactions)

No evidence for cardiovascular or thromboembolic effects with isotretinoin

MedWire News - Dermatology — Fri, 26 Aug 2011 00:00:00 +0100

Study findings suggest that there is no significant evidence for a link between isotretinoin treatment for acne and increased cardiovascular or thromboembolic side effects. (Source: MedWire News - Dermatology)

Dermatologists’ level of compliance with the prescription guidelines of isotretinoin for females of childbearing potential

International Journal of Dermatology — Sat, 20 Aug 2011 15:40:30 +0100

Conclusion Some dermatologists still do not follow the recommendations for isotretinoin prescription to FCBP. This needs to be corrected, especially in countries with restrictions on abortion. (Source: International Journal of Dermatology)

Sudden irreversible worsening of myopia with isotretinoin treatment

Indian Journal of Dermatology, Venereology and Leprology — Fri, 19 Aug 2011 23:00:00 +0100

Abir SaraswatIndian Journal of Dermatology, Venereology, and Leprology 2011 77(5):611-612 (Source: Indian Journal of Dermatology, Venereology and Leprology)

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Isotretinoin Associated Reversible Hypothyroidism

Thyroid — Thu, 11 Aug 2011 16:37:26 +0100

Thyroid , Vol. 0, No. 0. (Source: Thyroid)

Big Mountain Drugs Offers a Break to Teens Struggling with Acne

PRWeb: Medical Pharmaceuticals — Thu, 11 Aug 2011 07:17:43 +0100

The online Canadian pharmacy Big Mountain Drugs is offering teens struggling with both acne and the high price of acne medications a bargain on popular prescription acne treatments.(PRWeb August 08, 2011)Read the full story at http://www.prweb.com/releases/accutane/canada/prweb8698534.htm (Source: PRWeb: Medical Pharmaceuticals)

Isotretinoin: Deep venous thrombosis: case report

Reactions — Wed, 10 Aug 2011 17:36:32 +0100

(Source: Reactions)

Acne and Suicide

Psychology Today Depression Center — Mon, 01 Aug 2011 01:08:27 +0100

There have been many reports on acne, depression, and suicide over the years, mostly because a primary treatment for severe acne, isotretinoin (accutane), is known to increase the risk of depression and suicide.read more (Source: Psychology Today Depression Center)

Successful treatment of cyclosporine-induced sebaceous hyperplasia with oral isotretinoin in two renal transplant recipients.

The Australasian Journal of Dermatology — Sun, 31 Jul 2011 23:00:00 +0100

We present two cases of cyclosporine-induced sebaceous hyperplasia in renal transplant recipients, successfully treated with isotretinoin. Both patients tolerated isotretinoin well, with no alteration in graft function. These cases provide support for the safe and effective use of oral isotretinoin in the treatment of cyclosporine-induced sebaceous hyperplasia in the kidney transplant population. PMID: 21834824 [PubMed - in process] (Source: The Australasian Journal of Dermatology)

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Tretinoin and Isotretinoin Equally Effective for Photoaging

Rheumatology News — Sun, 31 Jul 2011 23:00:00 +0100

Major Finding: Oral isotretinoin and topical tretinoin both reduced facial actinic keratoses by 74% after 6 months and 54% after 12 months. (Source: Rheumatology News)

Isotretinoin/warfarin interaction: Vascular complications in elderly patients: 2 case reports

Reactions — Wed, 20 Jul 2011 16:58:58 +0100

(Source: Reactions)

Isotretinoin increases skin‐surface levels of neutrophil gelatinase‐associated lipocalin in patients treated for severe acne

British Journal of Dermatology — Wed, 20 Jul 2011 16:16:44 +0100

Conclusions These data support the hypothesis that NGAL is an important mediator of the early effects of isotretinoin on the sebaceous glands and provide insights into the mechanisms that regulate NGAL expression in the skin. (Source: British Journal of Dermatology)

Isotretinoin and iPledge: A view of results

Journal of the American Academy of Dermatology — Sat, 16 Jul 2011 16:19:54 +0100

Since its approval by the Food and Drug Administration (FDA) in 1982, isotretinoin has positively affected the lives of countless patients. Of course, any pharmaceutical agent has both its desired effect as well as undesirable side effects. The prescription of any given drug for any individual patient depends on the risk-benefit analysis for that patient. The side effect of teratogenicity has naturally moved to the forefront of safety standards for isotretinoin. It is important to remember that fetal exposure is the problem, not pregnancy itself, and all attention and efforts should be focused on preventing such exposure. (Source: Journal of the American Academy of Dermatology)

Could higher doses of isotretinoin reduce the frequency of treatment failure in patients with acne?

Journal of the American Academy of Dermatology — Sat, 16 Jul 2011 16:19:54 +0100

To the Editor: The current literature suggests that a lower cumulative dose of isotretinoin may increase the risk of acne relapse. We hypothesized that a higher cumulative dose could result in fewer cases of acne relapse and/or retrials of isotretinoin. “Relapse” for the purposes of our study was defined as acne necessitating a prescription medication after a course of isotretinoin; “retrial” was defined as recurrent acne severe enough to necessitate a second course of isotretinoin. We performed a retrospective chart review to identify patients with acne treated with isotretinoin for at least 4 consecutive months. We excluded cases followed up for less than 1 year. (Source: Journal of the American Academy of Dermatology)

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Improving the Isotretinoin Photostability by Incorporating in Microemulsion Matrix

Advances in Urology — Thu, 14 Jul 2011 17:39:48 +0100

The present paper demonstrates the increased photostability of isotretinoin when loaded in microemulsion. The photodegradation of isotretinoin, in methanol and microemulsion formulation was studied under direct sun light. The photodegradation process was monitored by UV spectrophotometry. In methanol solution, isotretinoin undergoes complete photodegradation just within a few minutes of light exposure. Isotretinoin incorporated in microemulsion formulation showed an increased stability in comparison to the methanol solutions. In particular for isotretinoin, a residual concentration of 75% was still present after a light irradiance versus a residual value of just 16% measured at the same time in methanol solution. Further, degradation kinetic parameters of isotretinoin-loaded microe...

Isotretinoin: Osteophyte formation in a child: case report

Reactions — Wed, 13 Jul 2011 16:51:36 +0100

(Source: Reactions)

Ranbaxy recalls skin care capsules Isotretinoin from UK market

The Economic Times Healthcare and Biotech News — Thu, 07 Jul 2011 07:19:14 +0100

Ranbaxy Laboratories is recalling all unexpired stock of Isotretinoin 20-mg capsules from the UK market following a directive from the EC. (Source: The Economic Times Healthcare and Biotech News)

Company-led drug recall: Isotretinoin 20mg capsules (Ranbaxy UK Ltd)

NeLM - News — Wed, 06 Jul 2011 23:00:00 +0100

Source: MHRA Area: News Ranbaxy (UK) Limited is recalling all unexpired stock of Isotretinoin 20mg capsules (PL 14894/0162) following a decision made by the European Commission that the marketing authorisation should be suspended as a temporary measure. This is due to a potential issue with bioequivalence in comparison with the originator product. For medical information enquiries, call 0208 7425292 and for stock enquiries, 0208 7425299 (Source: NeLM - News)

Combination of Low-Dose Isotretinoin and Pulsed Oral Azithromycin in the Management of Moderate to Severe Acne: A Preliminary Open-Label, Prospective, Non-Comparative, Single-Centre Study

Clinical Drug Investigation — Wed, 06 Jul 2011 14:48:54 +0100

(Source: Clinical Drug Investigation)

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Isotretinoin: Ulcerative colitis: case report

Reactions — Sun, 03 Jul 2011 18:34:01 +0100

(Source: Reactions)

Oral isotretinoin is first-line treatment in severe nodular acne, with other agents indicated as second-line or adjunctive therapy

Drugs — Sun, 03 Jul 2011 18:34:00 +0100

(Source: Drugs)

Refractory Hailey-Hailey disease successfully treated with sandpaper dermabrasion.

Skinmed — Fri, 01 Jul 2011 04:00:00 +0100

Authors: LeBlanc KG, Wharton JB, Sheehan DJ Abstract A 53-year-old woman presented with a 20-year history of pruritic dermatitis on the groin, axillae, inframammary folds, posterior aspect of the neck, and popliteal fossae. She was referred to our clinic by an outside facility after results from a punch biopsy diagnosed Hailey-Hailey disease (HHD). The patient had previously attempted treatment with many traditional noninvasive options with no success. Topical treatment modalities included corticosteroids, immunomodulators, antifungals, retinoids, and antibiotic preparations. Intralesional corticosteroids, as well as botulinum toxin and carbon dioxide laser, were also unsuccessful. Failed systemic treatment modalities included antibiotics, antihistamines, prednisone, azathioprine, ...

Off the Beaten Renin–Angiotensin–Aldosterone System Pathway: New Perspectives on Antiproteinuric Therapy

Advances in Chronic Kidney Disease — Thu, 30 Jun 2011 23:00:00 +0100

CKD is a major public health problem in the developed and the developing world. The degree of proteinuria associated with renal failure is a generally well accepted marker of disease severity. Agents with direct antiproteinuric effects are highly desirable therapeutic strategies for slowing, or even halting, progressive loss of kidney function. We review progress on therapies acting further downstream of the renin–angiotensin–aldosterone system pathway (e.g., transforming growth factor-beta antagonism, endothelin antagonism) and on those acting independent of the renin–angiotensin–aldosterone system pathway. In all, we discuss 26 therapeutic targets or compounds and 2 lifestyle changes (dietary modification and weight loss) that have been used clinically for diabetic or nondiabetic...

Folliculitis et perifolliculitis capitis abscedens et suffodiens controlled with a combination therapy: Systemic antibiosis (Metronidazole Plus Clindamycin), dermatosurgical approach, and high-dose isotretinoin

Indian Journal of Dermatology — Wed, 29 Jun 2011 23:00:00 +0100

Georgi TchernevIndian Journal of Dermatology 2011 56(3):318-320Folliculitis et perifolliculitis capitis abscedens et suffodiens is a rare disease of unknown etiology. It is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. The condition is also known as 'acne necrotica miliaris' or 'Proprionibacterium' folliculitis. Most often the disease affects men of African-American or African-Caribbean descent between 20 and 40 years of age. The clinical picture is determined by fluctuating painful fistule-forming conglomerates of abscesses in the region of the occipital scalp. The cause of scalp folliculitis is not well understood. It is generally considered to be an inflammatory reaction to components of t...

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Nosology and therapeutic options for lupus miliaris disseminatus faciei

The Journal of Dermatology — Wed, 29 Jun 2011 16:46:56 +0100

AbstractLupus miliaris disseminatus faciei (LMDF) is a distinctive facial eruption of a debatable nosology, unknown etiology and spontaneously resolving course albeit with scarring. The aim of this study was to present the clinico‐histopathological features, the rationale for treating and therapeutic response in patients with LMDF treated with different agents, and to attempt to clarify its nosology. Clinical details and demographic data of 29 biopsy‐proven cases of LMDF were studied. Laboratory work up included complete blood count, erythrocyte sedimentation rate, tuberculin testing, chest X‐ray, serum calcium levels and serum angiotensin‐converting enzyme levels. Special stains like Ziehl–Neelsen, periodic acid Schiff and reticulin staining were used, and acid‐fast bacilli cu...

Acne treatment and inflammatory bowel disease: What is the evidence?

Journal of the American Academy of Dermatology — Sun, 26 Jun 2011 23:00:00 +0100

To the Editor: The association between inflammatory bowel disease (IBD) and acne treatment has gained much attention from the media and has led to legal concerns. We aim to inform dermatologists of studies examining the link between IBD and isotretinoin, and IBD and tetracyclines, as such studies have primarily been published in the gastroenterology literature. PubMed queries (“isotretinoin,” “antibiotic,” “tetracycline,” “minocycline,” or “doxycycline” followed by “inflammatory bowel disease,” “Crohn disease,” or “ulcerative colitis”) yielded 10 pertinent studies. (Source: Journal of the American Academy of Dermatology)

Combined therapy with 131I and retinoic acid in Korean patients with radioiodine-refractory papillary thyroid cancer

European Journal of Nuclear Medicine and Molecular Imaging — Wed, 22 Jun 2011 15:57:02 +0100

Conclusion 131I/RA therapy was found to elicit a response rate of 21.3% among patients with radioiodine-refractory PTC, and an age of <45 years was found to be significantly associated with a good response. Content Type Journal ArticlePages 1-8DOI 10.1007/s00259-011-1849-2Authors So Won Oh, Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehang-Ro, Jongno-Gu, Seoul, 110–744 Republic of KoreaSeung-hwan Moon, Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehang-Ro, Jongno-Gu, Seoul, 110–744 Republic of KoreaDo Joon Park, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of KoreaBo Youn Cho, Department of Internal Medicine, Seoul National...

Isotretinoin Therapy and Inflammatory Bowel Disease [Evidence-Based Dermatology: Research Commentary]

Archives of Dermatology — Sun, 19 Jun 2011 23:00:00 +0100

(Source: Archives of Dermatology)

Include Discussions and Review of Systems Regarding Inflammatory Bowel Disease in Patients Starting Isotretinoin Therapy: Comment on "Isotretinoin Therapy and Inflammatory Bowel Disease" [Practice Gaps]

Archives of Dermatology — Sun, 19 Jun 2011 23:00:00 +0100

(Source: Archives of Dermatology)

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Successful treatment of cyclosporine‐induced sebaceous hyperplasia with oral isotretinoin in two renal transplant recipients

Australasian Journal of Dermatology — Wed, 08 Jun 2011 23:00:00 +0100

We present two cases of cyclosporine‐induced sebaceous hyperplasia in renal transplant recipients, successfully treated with isotretinoin. Both patients tolerated isotretinoin well, with no alteration in graft function. These cases provide support for the safe and effective use of oral isotretinoin in the treatment of cyclosporine‐induced sebaceous hyperplasia in the kidney transplant population. (Source: Australasian Journal of Dermatology)

Prescribed drugs and violence: a case/noncase study in the French PharmacoVigilance Database

European Journal of Clinical Pharmacology — Tue, 07 Jun 2011 15:50:50 +0100

Conclusion Dopaminergic agonists, benzodiazepines and serotoninergic antidepressants are the main pharmacological classes able to induce aggressive behaviour. This study also emphasises the putative role of other drugs less known to be involved in such ADR. Content Type Journal ArticlePages 1-10DOI 10.1007/s00228-011-1067-7Authors Nadège Rouve, Service de Pharmacologie Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d’Information sur les Médicaments, Centre Hospitalier Universitaire de Toulouse, Toulouse, FranceHaleh Bagheri, Service de Pharmacologie Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d’Information sur les Médicaments, Centre Hospitalier Universitaire de Toulouse, Toulouse, ...

Commentary: acne, isotretinoin and suicide attempts. - Margolis DJ.

SafetyLit: All (Unduplicated) — Mon, 06 Jun 2011 15:28:01 +0100

[Abstract unavailable] Language: Eng... (Source: SafetyLit: All (Unduplicated))

Acne, isotretinoin and suicide attempts: A critical appraisal. - Langan SM, Batchelor JM.

SafetyLit: All (Unduplicated) — Mon, 06 Jun 2011 15:28:01 +0100

Aim Sundström et al. (BMJ 2010; 341: c5812) aimed to assess suicide risk before, during and after isotretinoin treatment. Hypothesis People with severe acne may be at higher risk of attempted suicide regardless of exposure to isotretinoin. Setting ... (Source: SafetyLit: All (Unduplicated))

Response to acne, isotretinoin and suicide attempts: a critical appraisal. - Sundström A, Alfredsson L, Sjölin-Forsberg G, Gerdén B, Bergman U, Jokinen J.

SafetyLit: All (Unduplicated) — Mon, 06 Jun 2011 15:28:01 +0100

[Abstract unavailable] Language: Eng... (Source: SafetyLit: All (Unduplicated))

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Partial response to etanercept in the treatment of hidradenitis suppurativa.

Farmacia Hospitalaria — Sun, 05 Jun 2011 23:00:00 +0100

CONCLUSIONS: The treatment of hidradenitis suppurativa is based on antibiotics, corticosteroids or contraceptives. These are able to control the disease temporarily. Etanercept is well tolerated but it only results in an initial improvement. Similar results have been found with infliximab and adalimumab. The affected areas can be controlled with surgery. Therefore, the role of TNF inhibitors in the treatment of hidradenitis suppurativa is controversial. PMID: 21652252 [PubMed - as supplied by publisher] (Source: Farmacia Hospitalaria)

Effective monitoring of isotretinoin safety in a pediatric dermatology population: A novel “patient symptom survey” approach

Journal of the American Academy of Dermatology — Tue, 31 May 2011 23:00:00 +0100

Conclusions: The isotretinoin symptom survey appears to be an effective screening tool to standardize monitoring of isotretinoin side effects in the pediatric population. (Source: Journal of the American Academy of Dermatology)

The effect of oral isotretinoin (13‐cis retinoic acid) on hearing systems in patients with acne vulgaris: a prospective study

International Journal of Dermatology — Mon, 30 May 2011 16:19:24 +0100

The objective of this prospective study was to investigate whether oral isotretinoin could affect the hearing system. Thirty‐eight patients with acne vulgaris (76 ears) who were diagnosed and treated at the Department of Dermatology were included in the current study. Study evaluation visits were performed at baseline and at Weeks 1, 2 and 3. Pure‐tone averages (PTAs) of air conduction thresholds at 250 Hz (PTA1); 500, 1000, and 2000 Hz (PTA2); 4000, 8000, and 10, 000 Hz (PTA3); and 12, 500, 16, 000, 18, 000 and 20, 000 Hz (PTA4) for each ear were calculated separately. Assessment of the efficacy was based on the audiometric findings. Compared with pre‐treatment evaluation, the PTAs of patients were found to be significantly different at the first week for PTA2 (P�...

Acne, isotretinoin and suicide attempts: a critical appraisal.

The British Journal of Dermatology — Sun, 29 May 2011 08:46:27 +0100

Conclusions Sundström et al. (BMJ 2010; 341: c5812) conclude that there was an increased risk of suicide attempts up to 6 months after the end of treatment with isotretinoin and advise close monitoring for up to a year after completing a course of treatment. Patients with a history of suicide attempts before treatment made fewer new attempts at suicide than those where suicidality was observed in connection with treatment, suggesting that patients with severe acne with a history of attempted suicide should not automatically be refused isotretinoin treatment. The authors also state that suicide risk was already rising prior to treatment and that the additional risk cannot therefore be attributed to isotretinoin use. PMID: 21615370 [PubMed - in process] (Source: The British Journa...

Response to acne, isotretinoin and suicide attempts: a critical appraisal.

The British Journal of Dermatology — Sun, 29 May 2011 08:46:20 +0100

Authors: Sundström A, Alfredsson L, Sjölin-Forsberg G, Gerdén B, Bergman U, Jokinen J PMID: 21615371 [PubMed - in process] (Source: The British Journal of Dermatology)

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Commentary: acne, isotretinoin and suicide attempts.

The British Journal of Dermatology — Sun, 29 May 2011 08:46:16 +0100

Authors: Margolis DJ PMID: 21615372 [PubMed - in process] (Source: The British Journal of Dermatology)

Low dose Isotretinoin in Acne Vulgaris – A Critical Review

British Journal of Dermatology — Fri, 27 May 2011 23:00:00 +0100

(Source: British Journal of Dermatology)

Low‐dose isotretinoin in acne vulgaris: a critical review

British Journal of Dermatology — Fri, 27 May 2011 23:00:00 +0100

(Source: British Journal of Dermatology)

Commentary: acne, isotretinoin and suicide attempts

British Journal of Dermatology — Thu, 26 May 2011 16:14:55 +0100

(Source: British Journal of Dermatology)

Acne, isotretinoin and suicide attempts: a critical appraisal

British Journal of Dermatology — Thu, 26 May 2011 16:14:54 +0100

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Response to acne, isotretinoin and suicide attempts: a critical appraisal

British Journal of Dermatology — Thu, 26 May 2011 16:14:54 +0100

(Source: British Journal of Dermatology)

Isotretinoin: Pyogenic granuloma: 4 case reports

Reactions — Wed, 18 May 2011 17:09:57 +0100

(Source: Reactions)

Isotretinoin does not negatively affect sleep or executive function

MedWire News - Dermatology — Fri, 13 May 2011 00:00:00 +0100

Results from two studies suggest that contrary to previous claims, the acne medication isotretinoin does not adversely affect sleep or parameters of executive function. (Source: MedWire News - Dermatology)

The impact of the iPLEDGE program on isotretinoin fetal exposure in an integrated health care system

Journal of the American Academy of Dermatology — Thu, 12 May 2011 04:00:00 +0100

Conclusion: Evaluating the impact of iPLEDGE on isotretinoin fetal exposures is important in understanding the full risks and benefits of isotretinoin treatment. We found no evidence that iPLEDGE significantly decreased the risk of fetal exposure in FCBP compared to the SMART program. (Source: Journal of the American Academy of Dermatology)

TRAIL contributes to the apoptotic effect of 13‐cis retinoic acid in human sebaceous gland cells

British Journal of Dermatology — Wed, 11 May 2011 23:00:00 +0100

Conclusions: Taken together, our data suggests that TRAIL, like the neutrophil gelatinase‐associated lipocalin is involved in mediating 13‐cis RA apoptosis of sebocytes. (Source: British Journal of Dermatology)

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TRAIL contributes to the apoptotic effect of 13-cis retinoic acid in human sebaceous gland cells.

The British Journal of Dermatology — Wed, 11 May 2011 23:00:00 +0100

Conclusions: Taken together, our data suggests that TRAIL, like the neutrophil gelatinase-associated lipocalin is involved in mediating 13-cis RA apoptosis of sebocytes. PMID: 21564055 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)

Memory disorders associated with drugs consumption: updating through a case / non‐case study in the French PharmacoVigilance Database

British Journal of Clinical Pharmacology — Mon, 09 May 2011 23:00:00 +0100

Conclusions Our study confirmed an association between memory disorders and some drugs like benzodiazepines or anticonvulsants. But other drugs like hypnotics “benzodiazepines‐like”, newer anticonvulsants, SRI antidepressants, isotretinoin and cyclosporine were significantly associated with memory disorders although it was not or poorly described in literature.Taking account of limits of this study in the FPVD (under‐reporting, notoriety bias …), the case/non‐case method allows to assess and detect associations between drugs exposure and a specific adverse drug reaction such as memory disorders, and could thus generate signals and orientate us to further prospective studies to confirm such associations. (Source: British Journal of Clinical Pharmacology)

Use of topical tretinoin and the development of noncutaneous adverse events: Evidence from a systematic review of the literature

Journal of the American Academy of Dermatology — Mon, 09 May 2011 04:00:00 +0100

Conclusion: We found no clear evidence of a relationship between the use of topical tretinoin and the development of noncutaneous AE before a recent report of excess mortality in a clinical trial. The majority of noncutaneous AE reported by patients receiving topical retinoids consisted of nonsevere, nonspecific symptoms that were judged not to be related to treatment. (Source: Journal of the American Academy of Dermatology)

Multiple generalized xanthogranuloma in adult: Case report and treatment

Indian Journal of Dermatology — Wed, 04 May 2011 23:00:00 +0100

We report a case of a 28-year-old male patient who presented with multiple diffuse brown-to-yellowish papulonodular eruptions over extremities, ears, face, trunk, and extensors of joints with almost bilaterally symmetrical distribution for a period of one month. Histopathological examination of the skin biopsy specimen revealed features of xanthogranuloma. The patient was put on isotretinoin 20 mg once daily. Most of the lesions subsided or flattened within two months of isotretinoin therapy. This case is interesting because of the severity and atypical nature of the disease and also, the patient responded with isotretinoin therapy. But further study is required to observe the effectiveness of isotretinoin in xanthogranuloma. (Source: Indian Journal of Dermatology)

Effects of isotretinoin treatment on sleep in patients with severe acne: a pilot study

Journal of the European Academy of Dermatology and Venereology — Tue, 03 May 2011 23:00:00 +0100

Conclusions This study suggests that isotretinoin treatment slightly improves night‐time sleep without any effects on sleep stages and daytime sleepiness. (Source: Journal of the European Academy of Dermatology and Venereology)

Isotretinoin has no negative effect on attention, executive function and mood

Journal of the European Academy of Dermatology and Venereology — Tue, 03 May 2011 23:00:00 +0100

Conclusion The test battery used in this study, which is commonly used to evaluate mental status both in adults and children, did not show any negative effect of isotretinoin on executive functional parameters in acne patients. (Source: Journal of the European Academy of Dermatology and Venereology)

A single blind randomized clinical study: the efficacy of isotretinoin plus narrow band ultraviolet B in the treatment of psoriasis vulgaris

Photodermatology, Photoimmunology and Photomedicine — Tue, 03 May 2011 20:59:24 +0100

In this randomized clinical trial, 39 patients with psoriasis vulgaris were randomized in two groups. Intervention group received narrow band ultraviolet B (NBUVB)+isotretinoin (0.5 mg/kg/day), control group received NBUVB+placebo. Psoriasis Area Severity Index (PASI) scoring was recorded at baseline and weeks 4, 10, and 14. Thirty‐seven patients completed the study. According to recorded PASI scores the difference between efficacies of two treatments was not significant. Complete clearing was noticed in 14 and 13 patients in intervention group and controls. The mean cumulative NBUVB dose in intervention group and controls was 29.95 ± 16.11 vs. 45.77 ± 7.72 J/cm2 (P=0.004). Isotretinoin+NBUVB can reduce number of phototherapy sessions and cumulative NBUVB dose. (Source: Photodermat...

Oral azithromycin for treatment of intractable rosacea.

J Korean Med Sci — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Kim JH, Oh YS, Choi EH Rosacea is a common chronic cutaneous disorder that primarily occurs on the convex surfaces of the central face and is often characterized by exacerbations and remissions. A case of a 52-yr-old woman visited our clinic in February 2008 complaining typical features of rosacea including multiple pinhead to rice-sized erythematous papules. We applied various conventional treatments including topical benzoyl peroxide and metronidazole as well as oral metronidazole, isotretinoin, and doxycycline. The lesions were not controlled but were rather aggravated by complications from these treatments. Therefore, we prescribed oral azithromycin, which has anti-inflammatory effects and reduces reactive oxygen species. Ten weeks after the administration of oral azithrom...

On isotretinoin dosing, adverse effects, and efficacy

Australasian Journal of Dermatology — Sat, 30 Apr 2011 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

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On isotretinoin dosing, adverse effects, and efficacy: response.

Australasian Journal of Dermatology — Sat, 30 Apr 2011 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

On isotretinoin dosing, adverse effects, and efficacy.

The Australasian Journal of Dermatology — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Berk DR PMID: 21605103 [PubMed - in process] (Source: The Australasian Journal of Dermatology)

Lasers for vascular lesions: Standard guidelines of care

Indian Journal of Dermatology, Venereology and Leprology — Mon, 18 Apr 2011 23:00:00 +0100

CR Srinivas, M KumaresanIndian Journal of Dermatology, Venereology, and Leprology 2011 77(3):349-368Introduction: Lasers are a good therapeutic tool for congenital and acquired vascular lesions. Technological advances in lasers have reduced the adverse effects and increased the efficacy. Machines: Among the various lasers used for treating vascular lesions, pulsed dye laser (PDL) has the best efficacy and safety data. The other machines that are widely available are Nd:YAG laser and intense pulse light (IPL). Rationale and scope of guideline: Much variation exists in different machines and techniques, and therefore, establishing standard guidelines has limitations. The guidelines recommended here indicate minimum standards of care for lasers on vascular lesions based on current evidence. P...

Depression and acitretin: a true association or a class labeling? - Hayes J, Koo J.

SafetyLit: All (Unduplicated) — Fri, 15 Apr 2011 02:42:40 +0100

The potential relationship between systemic retinoids used in dermatology and affective disorders is controversial. Acitretin, which is widely used in the treatment of psoriasis is part of this controversy secondary to its chemical relation to isotretinoin... (Source: SafetyLit: All (Unduplicated))

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Preclinical evaluation of lestaurtinib (CEP-701) in combination with retinoids for neuroblastoma

Cancer Chemotherapy and Pharmacology — Mon, 11 Apr 2011 15:46:04 +0100

Conclusions The combination of 13cRA and CEP-701 was additive or synergistic in a spectrum of neuroblastoma cell lines, suggesting that these agents can be potentially studied together in the setting of minimal residual disease following intensive chemoradiotherapy for children with high-risk neuroblastoma. Content Type Journal ArticlePages 1-7DOI 10.1007/s00280-011-1623-yAuthors Robin E. Norris, Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USAJane E. Minturn, Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USAGarrett M. Brodeur, Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USAJohn M. Maris, Division of Oncology, The Children’s Hospital of Philadelphia, P...

Isotretinoin Increases Skin Surface Levels of Neutrophil Gelatinase‐Associated Lipocalin in Patients Treated for Severe Acne

British Journal of Dermatology — Mon, 04 Apr 2011 23:00:00 +0100

Conclusions: These data support the hypothesis that NGAL is an important mediator of the early effects of isotretinoin on the sebaceous glands and provide insights into the mechanisms that regulate NGAL expression in the skin. (Source: British Journal of Dermatology)

Isotretinoin Increases Skin Surface Levels of Neutrophil Gelatinase-Associated Lipocalin in Patients Treated for Severe Acne.

The British Journal of Dermatology — Mon, 04 Apr 2011 23:00:00 +0100

Isotretinoin: Paronychia and pyogenic granuloma: case report

Reactions — Mon, 04 Apr 2011 16:58:12 +0100

(Source: Reactions)

Current state of acne treatment: Highlighting lasers, photodynamic therapy, and chemical peels.

Dermatol Online J — Fri, 01 Apr 2011 22:00:04 +0100

Authors: Kim RH, Armstrong AW Acne vulgaris continues to be a challenge to dermatologists and primary care physicians alike. The available treatments reflect the complex and multifactorial contributors to acne pathogenesis, with topical retinoids as first-line therapy for mild acne, topical retinoids in combination with anti-microbials for moderate acne, and isotretinoin for severe nodular acne. Unfortunately, these conventional therapies may not be effective against refractory acne, can lead to antibiotic resistance, and is associated with adverse effects. With the rise of new technologies and in-office procedures, light and laser therapy, photodynamic therapy, chemical peels, and comedo extraction are growing in popularity as adjunctive treatments and may offer alternatives to those ...

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Severe Acne, Suicide, & Isotretinoin Rx: A Risk Assessment

AAP Grand Rounds — Thu, 31 Mar 2011 23:00:00 +0100

(Source: AAP Grand Rounds)

Vascular Complications After Treatment with Low‐Dose Isotretinoin in Two Elderly Patients

Dermatologic Surgery — Thu, 31 Mar 2011 23:00:00 +0100

The authors have indicated no significant interest with commercial supporters. (Source: Dermatologic Surgery)

Effectiveness of Conventional, Low‐dose and Intermittent Oral Isotretinoin in the Treatment of Acne: A Randomized, Controlled Comparative study ‐ Response

British Journal of Dermatology — Thu, 17 Mar 2011 00:00:00 +0100

(Source: British Journal of Dermatology)

Effectiveness of Conventional, Low-dose and Intermittent Oral Isotretinoin in the Treatment of Acne: A Randomized, Controlled Comparative study - Response.

The British Journal of Dermatology — Thu, 17 Mar 2011 00:00:00 +0100

Authors: Berk DR PMID: 21410669 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)

Effectiveness of conventional, low‐dose and intermittent oral isotretinoin in the treatment of acne: a randomized, controlled comparative study: comment

British Journal of Dermatology — Thu, 17 Mar 2011 00:00:00 +0100

(Source: British Journal of Dermatology)

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Isotretinoin: Hip pain: case report

Reactions — Sun, 13 Mar 2011 17:03:03 +0100

(Source: Reactions)

Acne vulgaris treatment : The Current Scenario

Indian Journal of Dermatology — Thu, 10 Mar 2011 00:00:00 +0100

Sanjay K RathiIndian Journal of Dermatology 2011 56(1):7-13Acne Vulgaris is one of the most common skin disorders which dermatologists have to treat. It mainly affect adolescent, though may present at any age. In recent years, due to better understanding of the pathogenesis of acne, new therapeutic modalities and various permutation and combinations have been designed. In topical agents; benzoyl peroxide, antibiotics, retinoids, etc are the mainstay of treatment; can be given in combinations. While systemic therapy includes oral antibiotics, hormonal therapy, and isotretinoin, depending upon the need of patients it has to be selected. Physical treatment in the form of lesion removal, photo-therapy is also helpful in few of them. Since various old and new topical and systemic agents are ava...

Rhabdomyolysis During Isotretinoin Therapy.

Actas Dermo-Sifiliograficas — Tue, 08 Mar 2011 00:00:00 +0100

Authors: Gómez-Bernal S, Rodríguez-Pazos L, Rodríguez-Granados MT, Toribio J PMID: 21392729 [PubMed - as supplied by publisher] (Source: Actas Dermo-Sifiliograficas)

Isotretinoin: Acute generalised exanthematous pustulosis: case report

Reactions — Sun, 06 Mar 2011 17:02:10 +0100

(Source: Reactions)

The Brown University Psychopharmacology Update — Sun, 06 Mar 2011 04:37:15 +0100

AbstractLamotrigine Outperforms Placebo in Study of Difficult‐to‐Treat DepersonalizationSSRI Response for Alcoholism Influenced by Age of Onset, GenesDrug Metabolism Genotype and Clozapine‐Induced PancreatitisInhaled Loxapine Promising for Agitation Linked to SchizophreniaLetter to the Editor: Comment on the February (2011) Nuedexta HandoutBright Light Treatment for Nonseasonal Major Depressive DisorderPsilocybin for Anxiety in Patients with Advanced‐Stage CancerAssociation of Suicide Attempts with Isotretinoin: Retrospective Swedish StudyStatins After a Cardiac Intervention May Reduce Risk of Subsequent DepressionParoxetine and Galactorrhea Without a Raised Prolactin LevelMislabeled Warfarin Bottles (Source: The Brown University Psychopharmacology Update)

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Treatment of acne vulgaris

Paediatrics and Child Health — Tue, 01 Mar 2011 00:00:00 +0100

Abstract: Acne vulgaris is a disorder of the pilosebaceous unit, characterized by comedones, inflammatory lesions and scars on the face and trunk. It presents a significant financial burden to the community and its psychosocial impact can be severe, life-altering and even life-threatening. Effective treatment can reduce the burden of disease but poorly considered therapy can be ineffective, costly and may also worsen non-compliance.In the management of acne, it is important to identify triggers, such as drugs, endocrinopathies and topical agents. Comedonal acne can respond well to topical retinoids. Mild to moderately inflammatory acne is usually initially treated with combination topical therapy, sometimes adding an oral antibiotic. Anti-androgen therapy can be helpful in females with seb...

THERAPEUTIC HOTLINE: Does isotretinoin have effect on vitamin D physiology and bone metabolism in acne patients?

Dermatologic Therapy — Tue, 01 Mar 2011 00:00:00 +0100

ABSTRACTIsotretinoin is an effective therapy for severe nodulocystic acne. Several experimental studies suggest that it may have an effect on vitamin D physiology. In the present study, the authors aimed to investigate the effect of isotretinoin treatment on the metabolism of vitamin D in acne patients. A prospective analysis of 50 consecutive acne patients who were treated with isotretinoin for 3 months was done. Before and after 3 months of treatment, 25 hydroxy vitamin D, 1,25 dihydroxy vitamin D, and bone alkaline phosphatase, calcium, phosphate, and parathormone levels were measured. The 25 hydroxy vitamin D and serum calcium levels decreased significantly (p < 0.0001, p < 0.05, respectively), whereas 1,25 dihydroxy vitamin D, parathormone, and bone alkaline phosphatase levels i...

Drug safety in pregnancy: Utopia or achievable prospect? Risk information, risk research and advocacy in Teratology Information Services

Congenital Anomalies — Tue, 22 Feb 2011 23:04:48 +0100

ABSTRACTEven though from preclinical testing to drug risk labeling, the situation with drugs in pregnancy has improved substantially since the thalidomide scandal, there is still an increasing need to provide healthcare professionals and patients with updated individualized risk information for clinical decision making. For the majority of drugs, clinical experience is still insufficient with respect to their safety in pregnancy. There is often uncertainty in how to interpret the available scientific data. Based on 20 years of experience with Teratology Information Services (TIS) cooperating in the European Network of Teratology Information Services (ENTIS) methods of risk interpretation, follow‐up of exposed pregnancies through the consultation process and their evaluation is discusse...

A case of spontaneous ovarian hyperstimulation syndrome

European Journal of Obstetrics, Gynecology, and Reproductive Biology — Fri, 11 Feb 2011 00:00:00 +0100

We report a case of spontaneous ovarian hyperstimulation syndrome. A 21-year-old para 2 woman was scanned at our Early Pregnancy Service at around 7 weeks of gestation for reassurance as she had completed a course of isotretinoin prior to conception. The scan showed a continuing intrauterine singleton pregnancy. Both ovaries were noted to be normal at the time. A further scan at 10 weeks was carried out following an episode of vaginal bleeding. A continuing pregnancy was diagnosed but both ovaries were found to be multicystic (L. ovary measuring 32mm×34mm, R. ovary 39mm×33mm). There was no evidence of ascites. This was a natural conception; there was no history of secondary infertility or use of drugs for ovulation induction. In the previous 4years she had had 2 vaginal deliveries follow...

High-Dose Isotretinoin for Acne Associated With Fewer Relapses

Medscape Internal Medicine Headlines — Tue, 08 Feb 2011 20:43:16 +0100

Medscape Medical News (Source: Medscape Internal Medicine Headlines)

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Assessment of Moisture, Melanin Content, Intensity of Erythema, Transepidermal Water Loss, pH, and Sebum Production in the Skin of Patients Treated with Oral Isotretinoin: A Preliminary Report.

Actas Dermo-Sifiliograficas — Fri, 04 Feb 2011 00:00:00 +0100

CONCLUSIONS: In our study we observed typical side effects of oral isotretinoin. This was only a preliminary study of 20 patients. Future work will focus on optimizing isotretinoin treatment to obtain the highest possible efficacy while also reducing the skin and mucosal side effects that are present in most patients. PMID: 21296312 [PubMed - as supplied by publisher] (Source: Actas Dermo-Sifiliograficas)

Compliance with pregnancy prevention programmes of isotretinoin in Europe: a systematic review

British Journal of Dermatology — Fri, 28 Jan 2011 15:28:59 +0100

SummaryMost of the publications on isotretinoin, pregnancy and compliance with the pregnancy prevention programme (PPP) originate from North America. Information specific for the European situation is very limited. The aim of this study was to identify publications describing the use of isotretinoin in humans and the compliance with the PPP in Europe, a systematic search in Medline and Embase was conducted using the terms ‘isotretinoin, pregnancy (and Europe)’. Furthermore, a manual search in publications was performed. A total of 17 publications were identified. Publications consisted of case reports of exposed pregnancies, surveys among dermatologists or pharmacists and database studies evaluating compliance with the PPP. The studies and surveys dealt with groups of patients exposed ...

Acne Treatments: Weighing Up Your Options

Health News from Medical News Today — Thu, 27 Jan 2011 10:00:00 +0100

There is no single acne treatment that's best for everyone. The right treatment for you will depend on many things, such as how severe your acne is and whether you can accept the side effects. For example, severe acne can often be cleared with a medicine called isotretinoin - but did you know it can cause serious birth defects in women? If you're aware of the pros and cons of different acne treatments, you will be fully informed when discussing the best way to clear your spots with your doctor. So here's a summary of the main considerations for each treatment... (Source: Health News from Medical News Today)

Improvement of Nonbullous Congenital Ichthyosiform Erythroderma Following Functional Endoscopic Sinus Surgery

Pediatric Dermatology — Tue, 25 Jan 2011 00:00:00 +0100

We report the case of a child with congenital nonbullous ichthyosiform erythroderma on long‐term isotretinoin who developed progressively worsening ichthyosis along with recurrent bouts of sinusitis. Endoscopic sinus surgery revealed osteophytes, most likely an isotretinoin‐related adverse event, and post operatively the patient’s sinus disease and skin disease both dramatically improved. This case represents the first report, to our knowledge, of ichthyosis improving after endoscopic sinus surgery. (Source: Pediatric Dermatology)

Acne -- Any Alternatives to Isotretinoin and Antibiotics?

Medscape Today Headlines — Fri, 21 Jan 2011 15:17:24 +0100

In this case, the author offers available evidence on alternative therapies for acne, including tea tree oil, zinc, and fermented milk. Medscape Family Medicine (Source: Medscape Today Headlines)

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Systemic treatment of acne.

Tidsskrift for den Norske Laegeforening — Fri, 21 Jan 2011 00:00:00 +0100

We present systemic treatment options for patients with moderate to severe acne. Material and methods. The article is based on a non-systematic literature search in PubMed and clinical experience. Results. Moderate to severe acne should first be treated with systemic antibiotics combined with local treatment such as adapalene and/or benzoylperoxid, and if the response is inadequate, with systemic isotretinoin. Isotretinoin therapy should be considered early in the course of severe or scar- forming acne. Interpretation. Moderate to severe acne should be treated by systemic therapy combined with topical treatment targeting different pathogenic aspects. PMID: 21267031 [PubMed - as supplied by publisher] (Source: Tidsskrift for den Norske Laegeforening)

Low-dose isotretinoin effective for treating mild-to-moderate acne

MedWire News - Dermatology — Fri, 14 Jan 2011 00:00:00 +0100

A low cumulative-dose isotretinoin treatment regimen for mild-to-moderate acne is effective for inducing stable remission and preventing relapses, report researchers. (Source: MedWire News - Dermatology)

Isotretinoin, Severe Acne, and Suicide: A Complicated Story

Medscape Today Headlines — Thu, 13 Jan 2011 04:00:00 +0100

Isotretinoin use has been linked to suicide, but is the suffering from severe acne a risk factor in itself? Journal Watch (Source: Medscape Today Headlines)

Low‐cumulative dose isotretinoin treatment in mild‐to‐moderate acne: efficacy in achieving stable remission

Journal of the European Academy of Dermatology and Venereology — Wed, 29 Dec 2010 00:00:00 +0100

Conclusion Comparing our findings with published data, this isotretinoin‐sparing regimen was shown to be effective in inducing stable remission and preventing acne relapses in patients with mild‐to‐moderate acne. Low‐cumulative dose regimens may potentially lead to a lower incidence of side‐effects and to lower costs than higher doses. (Source: Journal of the European Academy of Dermatology and Venereology)

Secondary follicular mucinosis associated with systemic lupus erythematosus.

Dermatol Online J — Fri, 24 Dec 2010 19:00:02 +0100

Authors: O'Reilly K, Brauer J, Loyd A, Patel R, Walters R, Franks AG A 61-year-old woman presented with a five-month history of an intermittent eruption of papules and nodules on her face and neck. Past medical history included systemic lupus erythematosus. Histopathologic examination was consistent with secondary follicular mucinosis in association with systemic lupus erythematosus. This rare entity has been described in one prior report as a precursor to the clinical onset of systemic lupus erythematosus. Follicular mucinosis occurs as either a primary idiopathic form or a secondary form associated with either benign inflammatory processes or malignant conditions, such as cutaneous T-cell lymphoma. Numerous treatments for primary follicular mucinosis have been described, which includ...

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Long‐term results of acitretin therapy for hidradenitis suppurativa. Is acne inversa also a misnomer?

British Journal of Dermatology — Thu, 23 Dec 2010 16:04:01 +0100

Conclusions Acitretin appears to be an effective treatment for refractory HS, leading to reduction of pain from painful nodules and reducing the extent of the disease for a prolonged period. (Source: British Journal of Dermatology)

European CHMP concludes arbitration on generic isotretinoin from Ranbaxy (UK) Limited and recommends suspension of UK marketing authorisation

NeLM - News — Fri, 17 Dec 2010 00:00:00 +0100

Source: European Medicines Agency (EMA) Area: News The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has completed an arbitration procedure initiated because of disagreement among EU Member States regarding the authorisation of the generic isotretinoin-containing medicine Isotretinoin Ranbaxy (UK) Limited. This procedure was initiated because of concerns that bioequivalence of this medicine to the reference product Roaccutane had only been shown under fasting conditions but not under fed conditions, and that this could thus result in suboptimal dosing. The Committee concluded that bioequivalence with the reference product has not been shown according to current requirements and that the benefit-risk balance of this medicine is negative. The C...

Drug Safety in Pregnancy – Utopia or achievable prospect?

Congenital Anomalies — Wed, 15 Dec 2010 00:00:00 +0100

AbstractAlthough from preclinical tests to drug risk labelling the situation with drugs in pregnancy has improved substantially since the thalidomide scandal, there is still an increasing need to provide health care professionals and patients with updated individualized risk information for clinical decision making. For the majority of drugs clinical experience is still insufficient with respect to their safety in pregnancy. There is often uncertainty how to interpret the available scientific data. Based on 20 years experience with Teratology Information Services (TIS) cooperating in the European Network of Teratology Information Services (ENTIS) methods of risk interpretation, follow up of exposed pregnancies through the consultation process and their evaluation is discussed. Vitamin K an...

Acne, Treatment, and Suicide

Medscape Today Headlines — Tue, 14 Dec 2010 16:45:13 +0100

Does treatment with isotretinoin raise the suicide risk among patients with acne? Medscape Dermatology (Source: Medscape Today Headlines)