title: [Isotretinoin. How should it be used?].
abstract: Isotretinoin has been the most effective and long-lasting drug for the treatment of severe acne for more than 30 years and can achieve long-term remission in 70-80 % of patients after a single course. New findings concerning its influence on innate immunity, the modulation of growth factors or the time-dependent regulation of genes of inflammation or matrix metabolism contribute to an improved understanding of the dynamic mode of action of isotretinoin. The new evidence-based European S3-guideline recommends the use of Isotretinoin as a first-line medication for the treatment of severe papulopustular or conglobate acne, especially when prognostically unfavorable factors are present: family history of acne, early onset, marked seborrhea, localization on the trunk, scarring, psychosocial disability or persistent/late-type acne. The correlation of a cumulative dose of > 100-120 mg/kg with a reduced relapse rate can be regarded as established in patients with severe acne forms, whereas in milder, "off-label"-treated acne forms, a good clinical outcome can also be achieved with lower cumulative doses.
authors.affiliation: Universitätsklinik für Dermatologie und Venerologie, Otto-von-Guericke Universität, Leipziger Str. 44, 39120, Magdeburg.
authors.forename: A
authors.initials: A
authors.lastname: Thielitz
authors.forename: H
authors.initials: H
authors.lastname: Gollnick
mesh_terms: D000152:Acne Vulgaris / Q000175:diagnosis* / Q000188:drug therapy*; D003879:Dermatologic Agents / Q000008:administration & dosage; D003880:Dermatology / Q000592:standards*; D004305:Dose-Response Relationship, Drug; D005858:Germany; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin