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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 1998 October;133(5):333-6
Isotretinoin and severe acne: personal experience about relapses after long-term follow-up
Bettoli V., Lombardi A. R., Pazzaglia M., Virgili A.
Università degli Studi - Ferrara, Clinica Dermatologica
Background. The aim of this study is to contribute further information on the incidence and factors influencing acne recurrences after isotretinoin treatment and to improve the therapeutic protocol with reference to the total cumulative dose (TCD) basis.
Methods. This study has been performed on 32 patients affected by nodular-cystic acne and/or acne conglobata treated with oral isotretinoin. Clinical results and recurrences after a long lasting follow-up have been correlated with those of other authors.
Results. At the end of the period of treatment all the patients were cleared. Seven out of 32 patients (22%) showed a recurrence during the follow-up of 1-9 years (mean 5.2 years). Based on the recent data of the literature total cumulative dose (TCD) taken by every patients has been estimated. Correlating TCD with recurrences it has been observed that the patients that had received TCD lower than 100 mg/kg presented earlier and more severe recurrences than those who received TCD between 100 and 150 mg/kg.
Conclusions. The authors outline how it is important to reach a TCD at least of 100 mg/kg in order to reduce the frequence and severity of recurrences. Young age, presence of microcysts, endocrinological problems of female accordingly with most of the authors are indicated as a possible cause of increased incidence of recurrences.