DR Medhat MRCP

Isotretinoin
- Is an oral retinoid used in the treatment of severe acne.
- Two-thirds of patients have a long term remission or cure following a course of oral
isotretinoin
• Adverse effects
Teratogenicity: females MUST be using two forms of contraception (e.g.
Combined oral contraceptive pill and condoms).
Dry skin, eyes and lips: the most common side-effect of isotretinoin.
Nose bleeds (caused by dryness of the nasal mucosa).
Low mood
Raised triglycerides
Hair thinning
Benign intracranial hypertension: isotretinoin treatment should not be
combined with tetracyclines for this reason.
Acne rosacea
- Acne rosacea is a chronic skin disease of unknown aetiology.
• Features
Typically affects nose, cheeks and forehead
Flushing is often first symptom
Telangiectasia are common
Later develops into persistent erythema with papules and pustules
Rhinophyma (large, bulbous, ruddy nose).
Ocular involvement: blepharitis
Erythema , papules ,pustules
Rhinophyma
• Management
Topical metronidazole may be used for mild symptoms (i.e. Limited number of
papules and pustules, no plaques)
Systemic antibiotics e.g. Oxytetracycline for more severe disease .
High-factor sunscreen daily application.
Camouflage creams may help conceal redness
Laser therapy may be appropriate for patients with prominent telangiectasia
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