A Clinical and Biochemical Evaluation of Effectiveness of Isotretinoin in Patients with Nodulocystic Acne

Abstract

Background and Objective: Nodulocystic acne is a serious and most common among young people influencing their physical and emotional well being. The research was conducted to establish, how isotretinoin influenced health and symptoms of individuals diagnosed with nodulocystic acne who visited the Department of Dermatology, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry. The research took place during three years at Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry at Dermatology Department.

Material and Method: The study included 125 patients with nodulocystic acne, were selected from the patients attending Dermatology Department OPD, Sri Lakshmi Narayana Institute  of Medical Sciences, Puducherry. Women in reproductive age group or planning for pregnancy was tested for urine pregnancy test. All patients were evaluated for baseline CBC, blood glucose, liver function test, kidney function test and tests for fat in blood, ultrasound abdomen and pelvis was done for all the women to rule out PCOD. The patients began with 0.5mg/kg per day of isotretinoin which was given in a single dose. Patients were checked every month for a period of 15-20 weeks of treatment, patient was reviewed every month to check the improvements, how the disease responded and side effects. Every month end blood tests were done. Those patients who relapsed faster than three months following treatment were not given another course. At the end of every month blood tests complete blood count, liver function , kidney function  and lipid profile were done.

Results: The study showed most of that most of the study participants had a family history of nodulocystic acne, especially male patients (76%), as opposed to female patients. Most lesions were found on the patients faces (84%), followed by face and trunk (16%), and fewer patients had on the mid chest and upper arm (2.4%). The primary cause of nodulocystic acne was stress (64%), other reasons were extreme heat (8%), certain food habits (4%), and trying different cosmetic items & homemade solutions (24%). Majority of patients have lip related complaints (92%), muscle pain (4%), peeling of skin in the hands (1.6%), nose bleed (1.6%) . (36%) patients had nodulocystic acne for 10-12 months and (28%) had acne for  7-9 months .

Conclusion: isotretinoin helps to treat nodulocystic acne ,when started early, carefully monitored and also when stress and environment issues are also addressed.