Abstract:
Acne vulgaris is common dermatosis, which usually starts in adolescence and resolves by mid 20s.However in 7.17% of the Individuals acne persists beyond 25 years.
Aim: To assess the clinical and biochemical evaluation of the efficacy of isotretinoin in nodulocystic acne.
Objectives 1. To evaluate the efficacy of isotretinoin
(1) and to monitor the clinical improvement. 2. To study effectiveness of isotretinoin in reducing seborrhea, nodule count and the devastating cosmetic effects caused by nodulocystic acne. 3. To monitor the side effects during and after treatment
Materials and Methods: The 45 cases for the study were selected from the patients attending department of DVL at SIMS during the period JAN 2018 to JAN 2019. §
Nclusion Criteria 1.patients who had received earlier treatment for long periods of time in the form of systemic antibiotics, topical antibiotics, benzoyl peroxide, topical retinoids and failed to respond. 2.15-35yrs of age of either sex. §
Exclusion Criteria 1. Raised cholesterol levels, signs of depression, photosensitivity and those hyper sensitive to parabens were excluded from the study. 2. Females of child bearing age who were not practicing contraception, pregnant women and lactating women were excluded from the study.
Methods § Before starting Treatment, a UPT was done to exclude pregnancy. All patients were evaluated for baseline CBP, blood sugar, LFT (AST, ALT, alkaline phosphatase, serum bilirubin), RFT (blood urea, sr. creatinine), sr. lipid profile (sr.triglycerides, total cholesterol, LDL,HDL).Ultrasound abdomen and pelvis was done in women to rule out PCOD. Started on 0.5mg/kg per day of isotretinoin in single daily dose after meals. Evaluated every month for a period of 15-20 weeks. Follow up every month for 3 to 4months.At the end of every month CBP, LFT, RFT, lipid profile were done.
Results: Clinical improvement - 43 out of 45 patients 22.22%(10 patients out of the total 45)- flare up of acne, Dryness and fissuring of lips - 88%, xeroderma - 2%, 2% - epistaxis, myalgias - 4%, desquamation of the palms but not soles was observed - 2% patients, 2% - headache. All routine investigations, LFT, lipid profile were repeated after 1 month and after completion of treatment.Transient elevation in serum triglycerides and total cholesterol was seen in some but not significant enough to require stoppage of treatment or anti hyperlipidemic treatment. Follow up was done for a period of 3 months after completion of treatment.
