Treatment of Moderate Acne Vulgaris with 20 mg Isotretinoin/Day in Iraqi Patients

Abstract

Background: The efficacy of isotretinoin at 0.5-1 mg/kg per day in the treatment of acne is well established and considered safe, although it is sometimes not easily tolerated because of its side effects. Objective: To determine the effect of treatment of moderate acne with a lowest dose of isotretinoin for a shorter period than the standard higher dose. Patients &Methods: Open label therapeutic study. A total of 34 patients with moderate papulopustular acne were examined in the Department of Dermatology and Venereology, Ramadi Teaching Hospital, Anbar, Iraq from July 2007 to June 2008. Detailed history and clinical examination were performed for all patients, and a thorough laboratory tests were done before and after therapy. Patients were treated with a dosage of 20 mg/ day of isotretinoin for four months. And evaluation was done at each month. Then treatment was stopped and Patients were followed up every two months for another 4 months regarding both clinical and laboratory findings. Results: Thirty patients completed the study. Four dropped out for unknown reasons. There were 24 males and 6 females with male to female ratio of 4:1. Their age ranged between 15 -27 (20.3±3.7) years. Complete improvement was achieved in 28(93.5%) patients at the end of two months. Within four months there were two (6.5%) relapses. The most common side effects were mild cheilitis in all patients beginning with the first week of treatment, Mild xerosis in 20(66.5%) patients and epistaxis in 4(13%) patients. No increase in liver enzymes, serum triglyceride or serum cholesterol. Conclusion: Acne vulgaris can be treated with four months regimen of isotretinon 20 mg once daily with lower cost and less severe side effects than standard higher doses.Keyword: Isotretinoin, Moderate acne, Iraqi patients