title: Isotretinoin treatment in nodulocystic acne with and without polycystic ovary syndrome: efficacy and determinants of relapse.
abstract: BACKGROUND
  Isotretinoin is the most efficacious long-lasting treatment for acne; however, some factors, including polycystic ovary syndrome (PCOS), patient age, family history, and type and number of acne lesions, may lead to treatment resistance or relapse following treatment. The aim of this study was to compare the efficacy and permanence of systemic isotretinoin (SI) in nodulocystic acne patients with and without PCOS and to evaluate the factors associated with relapse during the first and second post-treatment years.
  
  
  METHODS
  The study included 96 female patients with nodulocystic acne. SI 0.5-1 mg/kg/dl was given, with a total cumulative dose of 120-150 mg/kg. Response to treatment and relapse during the first and second post-treatment years were evaluated.
  
  
  RESULTS
  In all, the 50 non-PCOS and 46 PCOS acne patients were similar. SI was similarly efficacious in both groups. In total, eight patients relapsed during the first post-treatment year, versus 16 during the second. Relapse during the first year was associated with the number of nodules at the start of treatment and the number of papulopustular lesions at the end of treatment, whereas PCOS, patient age, and the number of nodules at the start of treatment were associated relapse during the second year.
  
  
  CONCLUSIONS
  Regardless of its association with PCOS, SI was effective in the treatment of nodulocystic acne. The factors associated with relapse during the 1(st) and 2(nd) post-treatment years differed, except for the number of nodules at the start of treatment.
authors.affiliation: Department of Dermatology, Etimesgut State Hospital, Ankara, Turkey.
authors.forename: Gul Aslihan
authors.initials: GA
authors.lastname: Cakir
authors.forename: Fatma Gulru
authors.initials: FG
authors.lastname: Erdogan
authors.forename: Aysel
authors.initials: A
authors.lastname: Gurler
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000188:drug therapy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D044465:White People; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin