title: Efficacy of fixed low-dose isotretinoin (20 mg, alternate days) with topical clindamycin gel in moderately severe acne vulgaris.
abstract: BACKGROUND
  In view of the potentially serious side-effects of standard isotretinoin (0.5-1.0 mg/kg per day) therapy for acne, we studied the safety and efficacy of low-fixed dose isotretinoin plus topical 1%clindamycin gel in the treatment of moderate grade of acne.
  
  
  METHODS
  In this prospective, non-comparative study, 320 adult patients, with moderately severe acne were enrolled and treated with fixed-dose isotretinoin at 20 mg every alternate day (approximately 0.15 mg/kg/day to 0.28 mg/kg/day) for 6 months along with topical clindamycin gel. All female patients were assessed for polycystic ovarian disease. Patients were followed up for 6 months.
  
  
  RESULTS
  A total of 305 patients completed the study. Overall, patients received a mean of 38.4 mg/kg cumulative dose of isotretinoin, and very good results were observed in 208 (68.20%), while good response was seen in 59 (19.34%) of patients. Failure of the treatment occurred in 38 (12.46%), while relapses occurred in 50 (16.39%) of patients. Relapses were commoner in females, and 37 of 43 (86.04%) patients had polycystic ovarian disease. Though mild chelitis (91%) and xerosis (43%) were common, laboratory abnormalities in the form of elevated hepatic enzymes (5%) and elevated serum lipids (6%) were rare.
  
  
  CONCLUSIONS
  Six months of treatment with fixed-dose, alternate-day isotretinoin (20 mg) plus topical 1%clindamycin gel was found to be effective in the treatment of moderate acne in adult patients, with a low incidence of side-effects.
authors.affiliation: Department of Dermatology and STD, Maulana Azad Medical College and Lok Nayak Hospital Delhi. kabirijdvl@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Sardana
authors.forename: V K
authors.initials: VK
authors.lastname: Garg
authors.forename: V N
authors.initials: VN
authors.lastname: Sehgal
authors.forename: S
authors.initials: S
authors.lastname: Mahajan
authors.forename: P
authors.initials: P
authors.lastname: Bhushan
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002981:Clindamycin / Q000008:administration & dosage* / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D002981:Clindamycin; D015474:Isotretinoin