RESUMEN
CLINICAL RELEVANCE: Isotretinoin has been the best treatment option for moderate and severe acne vulgaris since the 1980s. Some studies have shown evidence of subclinical anterior segment involvement of the eye in patients treated with isotretinoin. BACKGROUND: This study aimed to evaluate lens clarity with the densitometry software of Scheimpflug tomography in patients treated with isotretinoin and to compare with healthy control subjects. METHODS: Thirty-seven acnepatients treated with isotretinoin who met the inclusion criteria (24 males and 13 females, mean age 22.94 ± 4.21 years) and 39 healthy control subjects were included in the study. Clinical characteristics of the isotretinoin and control subjects were recorded. Lens density was evaluated with the densitometry software of the Scheimpflug tomography device (PentacamHR, Oculus, Wetzlar, Germany). RESULTS: There was no statistically significant difference between the groups in age, gender distribution, spherical equivalent, or anterior segment parameters measured by the Pentacam system (p > 0.05 for all). Lens density values in zones 2 and 3 were significantly higher in the isotretinoin group (p = 0.042, p < 0.001) and positively correlated with cumulative isotretinoin dose (zone 2: r = 0.384, p = 0.032; zone 3: r = 0.384, p = 0.005). CONCLUSION: Zone 2 and zone 3 lens density are higher in patients treated with isotretinoin when compared to healthy controls.
RESUMEN
Cutaneous metastasis (CM) is a rare clinical entity with an incidence of less than 10% among oncology patients. Dissemination to the skin can be via bloodstream, lymphatics, direct expansion or by seeding after surgical procedures. Skin metastases usually develop months to years after the diagnosis of the primary tumor, while it may be the opposite in some rare cases. CM has various clinical presentations; diagnoses can be easily overseen as CM can mimic other dermatologic diseases. Herein, we present five different cutaneous metastasis cases, each with distinct dermatological presentation. Our main aim here is to allow dermatologists to consider skin metastases in the differential diagnoses of dermatological diseases, in their clinical practice.
RESUMEN
PURPOSE: The aim of this study was to evaluate the potential changes in choroidal vasculature in nodulocystic acne patients under isotretinoin treatment by using choroidal thickness (CT), choroidal vascularity index (CVI), and choriocapillaris (CC) flow area. MATERIALS AND METHODS: This prospective study included nodulocystic acne patients under isotretinoin treatment and healthy controls. All patients underwent enhanced depth imaging-optical coherence tomography (EDI-OCT) imaging to assess the subfoveal CT and submacular CVI, and optical coherence tomography angiography (OCTA) imaging to evaluate the CC flow area. RESULTS: A total of 25 patients with acne and 23 controls were included. The mean duration of the treatment was 7.20 ± 0.79 months and the mean daily isotretinoin dose was 38.7 ± 2.8 mg in the acne group. The mean CT and CVI values were significantly higher in the acne group compared to the control group (p = 0.005 and p = 0.027, respectively). The cumulative isotretinoin dose was positively correlated with subfoveal CT and submacular CVI (r = 0.434, p = 0.015 and r = 0.385, p = 0.033, respectively). Regarding the CC flow area, the values for area with a radius of 1 mm, 2 mm and 3 mm were lower in the acne group than in the control group; however, the difference was not significant (p > 0.05, all values). CONCLUSION: After a mean 7-month course of isotretinoin treatment, subfoveal CT and submacular CVI values were significantly higher in the nodulocyctic acne patients. Whether the choroidal changes are permanent or not should be investigated in future studies.
