title: Isotretinoin treatment alters steroid metabolism in women with acne.
abstract: The effect of isotretinoin (Roaccutane) on serum steroids and urinary steroid metabolites was investigated in seven female patients receiving the drug for treatment of severe acne over a 16-week period. Serum concentrations of dehydroepiandrosterone sulphate (DHAS), androstenedione (A2), and free androgen index (FAI) were not significantly altered. There was a significant fall in testosterone during treatment and a significant reduction in the 24 h urinary excretion of androsterone, tetrahydrocortisone (THE) and tetrahydrocortisol (THF) from week 8 onwards and for aetiocholanolone and allo-THF from week 12 (P less than 0.05). Although pretreatment levels of urinary steroid metabolites were not abnormal, the ratios of the 5 alpha/5 beta metabolites (androsterone:aetiocholanolone and allo-THF:THF) were at the upper limit of the reference range and were lowered after treatment, suggesting that 5 alpha-reductase activity is sensitive to isotretinoin.
authors.affiliation: Department of Dermatology, Glasgow Royal Infirmary, U.K.
authors.forename: M
authors.initials: M
authors.lastname: Rademaker
authors.forename: M
authors.initials: M
authors.lastname: Wallace
authors.forename: W
authors.initials: W
authors.lastname: Cunliffe
authors.forename: N B
authors.initials: NB
authors.lastname: Simpson
mesh_terms: D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase / Q000378:metabolism; D000152:Acne Vulgaris / Q000188:drug therapy* / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000378:metabolism*; D000738:Androsterone / Q000652:urine; D005043:Etiocholanolone / Q000652:urine; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood; D013760:Tetrahydrocortisol / Q000097:blood; D013761:Tetrahydrocortisone / Q000097:blood
chemical_list: D000728:Androgens; D013739:Testosterone; D013761:Tetrahydrocortisone; D013760:Tetrahydrocortisol; D005043:Etiocholanolone; D000738:Androsterone; D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase; D015474:Isotretinoin