title: Oral isotretinoin is as effective as a combination of oral isotretinoin and topical anti-acne agents in nodulocystic acne.
abstract: BACKGROUND
  Due to the late introduction of oral isotretinoin, there is only a single report of the use of this drug from India.
  
  
  OBJECTIVE
  To evaluate the efficacy, acceptability and side effects of oral isotretinoin in Indian conditions and to compare the efficacy of oral isotretinoin monotherapy with that of a combination of oral isotretinoin and topical anti-acne agents.
  
  
  METHODS
  Sixty clinically diagnosed patients of nodulocystic acne were divided into two groups of 30 each. Patients in group A were administered oral isotretinoin 20 mg twice a day along with topical clindamycin (1%) and adapalene (0.1%) for 24 weeks. Patients in group B were given only oral isotretinoin. An objective clinical scoring was repeated every four weeks and patients were followed up for six months on completion of treatment.
  
  
  RESULTS
  Out of the 60 patients, 50 completed the treatment and 35 completed the follow-up at six months. The mean pretreatment score in group A came down from 12.8 to 1.24 and in group B from 12.4 to 1.48, thus showing a 90.55% and 88% reduction in pretreatment scores respectively. There was no statistical difference in the results obtained from the two groups. Side effects were common but minor in nature.
  
  
  CONCLUSIONS
  Isotretinoin produces gratifying results in patients of nodulocystic acne in Indian conditions. Addition of topical antiacne agents does not alter the final outcome. This addition is well tolerated but requires careful monitoring.
authors.affiliation: Department of Dermatology, INHS Asvini, Mumbai, Maharashtra, India. dhir_rajeev@yahoo.com
authors.forename: Rajeev
authors.initials: R
authors.lastname: Dhir
authors.forename: Neetu P
authors.initials: NP
authors.lastname: Gehi
authors.forename: Reetu
authors.initials: R
authors.lastname: Agarwal
authors.forename: Yuvraj E
authors.initials: YE
authors.lastname: More
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000473:pathology; D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D002648:Child; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage*; D008297:Male
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin