Clinical and laboratory adverse effects of oral isotretinoin in patients with nodulo-cystic acne

Oral isotretinoin is the only drug that is effective on almost all factors involved in the pathogenesis of acne. Although several studies have been conducted on side effects of this drug, few studies have been conducted on Iranian patients. The aim of this study was to evaluate common clinical and laboratory side effects of this drug in patients with nodulo-cystic acne in Mashhad, Iran. One-hundred nodulo-cystic acne patients without previous history of hematologic, renal or hepatic diseases and with negative pregnancy tests (in female patients) were enrolled to this study. Patients were treated with standard regimen of oral isotretinoin with a cumulative dose of 120 mg/kg for a treatment course. Demographic data of each patient and results of baseline laboratory tests including serum lipids profile, liver function tests and cell blood counts were recorded. Laboratory tests and the clinical side effects were assessed every two months. All patients completed treatment course. The most common side effects were cheilitis (87%), dry skin (71%), various types of dermatitis (37%), epistaxis (21%), arthralgias and myalgias (21%). All side effects were mild and treatment discontinuation was not necessary in any case. Although some changes were observed in serum lipid profiles and liver function tests, but these changes were within normal range. Treatment with oral isotretinoin is associated with few complications in patients with nodulo-cystic acne, but the possibility of serious side effects should always be considered.