Acne Treatment with Accutane Isotretinoin Part 2

Dr. Thomas P. Habif, MD discusses Acne Treatment with Accutane Isotretinoin Part 2. See more at www.dermnet.com PLEASE RATE AND COMMENT!!! Isotretinoin treatment Part 2 Relapse, side effects, monitoring, depression Risk factors for relapse are: Young teenagers Back and chest acne Sinus tract lesions Excess granulation tissue Androgen excess There are several risk factors for recurrence. Patients with a high probability of relapse or failure with isotretinoin have been identified. Young teenagers with nodulocystic acne will clear with isotretinoin therapy but the chance of recurrence within 2 years is high. They may require 2 to 4 courses of therapy to maintain a durable remission. Patients with acne of the chest and back relapse more frequently. Patients who form epithelial sinus tracts have a poor response to therapy. These linear cystic structures extend with time as they propagate through the dermis. Isotretinoin and intralesional steroids may clear the lesions but surgical excision is often required. Female patients with androgen excess states present with acne. They relapse within 6 months of stopping isotretinoin. Oral contraceptives and spironolactone are appropriate treatments. Women with high abdominal fat content called android obesity have waist circumferences greater than 80 cm and waist-to-hip ratios greater than 0.8. They look like Humpty-Dumpty with large upper bodies, flat buttocks and thin legs. They have a high incidence of diabetes, increased …

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