title: A double-blind investigation of the potential systemic absorption of isotretinoin, when combined with chemical sunscreens, following topical application to patients with widespread acne of the face and trunk.
abstract: This study assessed the systemic absorption of isotretinoin and its metabolites, during a 4-week application of a cream containing 0.1% isotretinoin and chemical sunscreens, compared with a 4% benzoyl peroxide cream, in patients with acne on the face and trunk. Blood was drawn at weeks 0, 1, 2, 3 and 4 and at 96 h post-treatment. Plasma levels of isotretinoin (13-cis-retinoic acid) and tretinoin (all-trans-retinoic acid) were quantified by liquid chromatography with tandem mass spectrometry and the presence of their combined 4-oxo metabolites were monitored from the peak area ratios observed. The isotretinoin group showed no statistically or clinically significant increases in plasma retinoid levels and mean levels did not exceed +/-2 SD of the mean pre-treatment values, indicating that endogenous levels were not being exceeded. No significant differences were detected between the isotretinoin group and the 4% benzoyl peroxide group. These findings indicated that retinoid absorption from a cream containing 0.1% isotretinoin and chemical sunscreens was clinically insignificant, when applied to patients with widespread acne.
authors: Department of Dermatology, The General Infirmary at Leeds, UK.
authors: W J
authors: WJ
authors: Cunliffe
authors: D
authors: D
authors: Glass
authors: K
authors: K
authors: Goode
authors: G I
authors: GI
authors: Stables
authors: G C
authors: GC
authors: Boorman
mesh_terms: D000152:Acne Vulgaris / Q000175:diagnosis / Q000188:drug therapy*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D002648:Child; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005148:Facial Dermatoses / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012869:Skin Absorption / Q000187:drug effects; D013473:Sunscreening Agents / Q000494:pharmacology*; D013909:Thorax; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D013473:Sunscreening Agents; D015474:Isotretinoin