title: Oral isotretinoin for acne, adjusting treatment according to patient's response.
abstract: BACKGROUND
  Oral isotretinoin is an established effective therapy for acne. No published data is available on the efficacy and side effects of this drug in Iranian patients.
  
  
  METHODS
  A total of 132 acne patients with a mean age of 22.9 +/- 6.2 years were treated with oral isotretinoin (Roaccutane) and followed-up from 1999 through 2005. Each patient was started with a dose of 0.75 mg/kg per day until all active lesions healed, followed by a maintenance dose of 20 mg/kg per day for one more month. Laboratory tests were done at monthly intervals. Evaluation of clinical response was based on Leeds technique. Patients were followed-up for a mean period of 4.4 years.
  
  
  RESULTS
  Most of the patients had severe nodulocystic acne involving both trunk and face. Treatment was continued for 6.6 +/- 2.5 months with a cumulative dose of 111.5 mg/kg +/- 33.9. The mean final improvement rate was 96.7% (95% CI, 84.9% to 108.5%). There was no correlation between improvement rate and age, sex, duration of acne, length of treatment, or cumulative dose. Side effects were generally mild and treated conservatively. In the follow-up, period 18.35% experienced relapse after a mean interval of 1.28 years, 9.17% required a second course of isotretinoin, and only one case needed 3 courses of treatment.
  
  
  CONCLUSIONS
  Isotretinoin is an effective and safe treatment for acne in Iranian patients. Starting treatment with a high dose and modifying the length of treatment based on the therapeutic response in each patient, might lead to a rapid and good response rate with minimal side effects.
authors.affiliation: Department of Dermatology, Hazrat-e Rasool University Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Gholamhosein
authors.initials: G
authors.lastname: Ghaffarpour
authors.forename: Shadi
authors.initials: S
authors.lastname: Mazloomi
authors.forename: Razieh
authors.initials: R
authors.lastname: Soltani-Arabshahi
authors.forename: Kamran Soltani Arabshahi
authors.initials: KS
authors.lastname: Seyed
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000473:pathology; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin