ABSTRACT

Background:

Oral isotretinoin is widely used for acne vulgaris. It is an effective agent but has a wide spectrum of potential side-effects.

A clinical audit was carried out in a tertiary care hospital to determine current practice regarding oral isotretinoin use in acne vulgaris and to evaluate the association between adherence to guidelines and safety and efficacy profile

Material and Methods:

The data was obtained from the medical record of patients. It included details like age, gender, weight, duration of acne, method of calculation of severity of acne, history of depression and the scoring system used to assess it, previous treatments used for acne, total duration and dose of isotretinoin, monitoring of laboratory investigations before, during and at the end of treatment, response of the disease and side effect profile. Results were collated and analyzed on SPSS 17 statistical software

Results:

51.8% (207 patients) were female and 48.3% (193patients) were male, with mean age 22.3 +7.2 years. Mean cumulative dose of isotretinoin was 117.31 +- 28.64, with the majority of the patients (81.7%) receiving 80 – 150 mg/kg body weight. 347 (86%) of the patients had an excellent response with complete or near complete clearance of acne; 2 patients (0.5%) had a partial response with mild acne persisting at the time of discontinuation of therapy. 40 patients (10%) were lost to follow up and eleven (2.75%) discontinued treatment due to persistent side effects. Two patients, while on treatment, became pregnant and opted for therapeutic abortions.

Conclusion:

Results support the need to adhere to the current guidelines as oral isotretinoin is an effective and well-tolerated drug when used under supervision. Treating physicians need to be vigilant to monitor potential side effects.