title: The efficacy of oral isotretinoin versus cyproterone compound in female patients with acne and the triad of cutaneous hyperandrogenism: A randomized clinical trial.
abstract: BACKGROUND
  SAHA (Seborrhea, Acne, Hirsutism and Androgenetic Alopecia) syndrome is a dermatologic disorder, with variant response to treatment. Triad of cutaneous hyperandrogenism included nodulocystic or severe acne, female pattern hair loss and hirsutism.
  
  
  OBJECTIVE
  The aim of this study is to compare the effectiveness of isotretinoin and cyproterone compound in the treatment of nodulocystic acne, in patients with SAHA syndrome or triad of cutaneous hyperandrogenism.
  
  
  METHODS
  30 female patients with SAHA syndrome were divided randomly into two groups. Group A was treated with cyproterone compound from day 5 of menstrual cycle onwards for 3 weeks and a week without it and group B received isotretinoin, with a dose of 0.75 mg/kg per day from the beginning of menses onwards for 4 months. The results were evaluated by a blind dermatologist using Acne Severity Index (ASI) score at baseline and monthly for 4 months.
  
  
  RESULTS
  Despite a continuous reduction in ASI score in both the groups, according to both physician (P = 0.63) and patient (P = 0.25) assessment, cyproterone compound was not statistically more effective than conventional treatment of nodulocystic acne at the end of the study. Side-effects were reported in patients in both groups, generally being mild and tolerable except in two subjects.
  
  
  CONCLUSIONS
  This study indicates that cyproterone compound is not superior to isotretinoin in the treatment of nodulocystic acne in patient with SAHA syndrome or triad of cutaneous hyperandrogenism. Indeed, other studies are needed to evaluate the effect of cyproterone compound (regardless of androgen level) and isotretinoin in subjects with only nodulocystic acne.
authors.affiliation: Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gita
authors.initials: G
authors.lastname: Faghihi
authors.affiliation: Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Kioumars
authors.initials: K
authors.lastname: Jamshidi
authors.affiliation: Department of Dermatology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
authors.forename: Nabet
authors.initials: N
authors.lastname: Tajmirriahi
authors.affiliation: Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Abtahi-Naeini
authors.affiliation: Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamadali
authors.initials: M
authors.lastname: Nilforoshzadeh
authors.affiliation: Department of Dermatology Center, Noorand Ali Asghar Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamadreza
authors.initials: M
authors.lastname: Radan
authors.affiliation: Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sayed Mohsen
authors.initials: SM
authors.lastname: Hosseini
keywords: Acne; SAHA; cyproterone compound; hyperandrogenism; isotretinoin