The effectiveness of using different doses of systemic isotretinoin in adolescents with acne and overweight


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Abstract

Background. Acne is one of the most common dermatological diseases in the world. In terms of prevalence, it is in the top ten along with diseases such as atopic and seborrheic dermatitis, psoriasis and rosacea. The article includes an overview of the incidence of acne vulgaris in children and adolescents from different countries. Objective. Evaluation of the effectiveness of various regimens of therapy with isotretinoin in adolescents with acne vulgaris and overweight. Methods The study involved 20 patients aged 12 to 18 years with varying degrees of severity of acne and overweight. Depending on the isotretinoin regimen, patients were divided into 2 groups of 10 patients. The first group received a course of treatment with a gradual dose reduction, the initial daily dose of isotretinoin was 20-40 mg; the second received a course of isotretinoin without reducing the dosage. Results. It has been established that for severe nodular, conglobate and severe papulopustular acne in overweight adolescents, a course of treatment with isotretinoin is indicated. Isotretinoin is recommended at a dose of 20-40 mg until the stabilization of the process, then a dose should be reduced to 10-20 mg prescribed for 4-6 months, followed by drug withdrawal; for moderate papulopustular acne, it is possible to conduct a course of therapy with isotretinoin without reducing the dosage: the daily dose is 20-40 mg. Side effects from the skin and mucous membranes occur quite often, but have a temporary nature. Conclusion. For severe nodular, conglobate, and severe papulopustular acne in overweight adolescents, a course of treatment with isotretinoin at a dose of 20-40 mg until stabilization of the process with a subsequent reduction in dosage is indicated. For moderate papulopustular acne, a course of isotretinoin therapy without reducing the dosage can be recommended.

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About the authors

N. V Gryazeva

Central State Medical Academy of Department for Presidential Affairs of the Russian Federation

Email: tynrik@yandex.ru
Cand. Sci. (Med.), Associate Professor at the Department of Dermatovenereology and Cosmetology

A. A Kolody

Central State Medical Academy of Department for Presidential Affairs of the Russian Federation

Department of Dermatovenereology and Cosmetology

E. M Gensler

Central State Medical Academy of Department for Presidential Affairs of the Russian Federation

Department of Dermatovenereology and Cosmetology

References

  1. Halvorsen J.A., Vleugels R.A., Bjertness E., Lien L. A Population-Based Study of Acne and Body Mass Index in Adolescents. Arch Dermatol. 2012;148(1):131-32. Doi: 10.1001/ archderm.148.1.131
  2. Alkhabbaz M., Al-Taiar A., Saeed M., Predictors of Acne Vulgaris among Adolescents in Kuwait. Medical principles and practice. International journal of the Kuwait University, Health Science Centre. 2019. Doi: 10.1159/ 000503711.
  3. Karadag A.S., Tutal E., Ertugrul D.T., Akin K.O. Effect of isotretinoin treatment on plasma holotranscobalamin, vitamin B12, folic acid, and homocysteine levels: non-controlled study. Int J Dermatol 2011;50:1564-69

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