Evaluation of hematological parameters in patients using systemic isotretinoin with diagnosis of acne vulgaris.

OBJECTIVES: Oral isotretinoin is the most effective treatment option in patients with acne. However, it can cause various hematologic and biochemical abnormalities. This study aimed to evaluate hematologic abnormalities during oral isotretinoin treatment in patients with acne. MATERIAL AND METHODS: In this cross-sectional study, the hematologic and inflammatory parameters of 138 patients with acne using 0.3-1 mg/kg/day oral isotretinoin for at least 6 months were retrospectively analyzed. RESULTS: In the study, the female-to-male ratio was 2.83, and the mean age of the patients was 23.1 ± 5.8 years. At the third and sixth months of isotretinoin treatment, there was a statistically significant decrease in the neutrophil count compared to the pre-treatment values (p = 0.003 and p = 0.032, respectively). The platelet count showed the most statistically significant increase (p < 0.001) at the first month of treatment. The most statistically significant decrease in the neutrophil-to-lymphocyte ratio (NLR) was observed at the third month of treatment (p < 0.001). No significant changes were observed in hemoglobin, hematocrit, white blood cell count, mean corpuscular volume, and mean platelet volume. CONCLUSIONS: There was a decrease in neutrophils and NLR and an increase in platelets during isotretinoin treatment, and these changes were usually mild. However, it would be appropriate to monitor blood counts during treatment in patients with neutropenia or thrombocytosis.

Isotretinoin-induced visual hallucinations in a patient with acne vulgaris.

Oral isotretinoin is an effective treatment for severe acne. However, psychiatric side effects are noted, including a few cases of psychosis and mania triggered by isotretinoin. In this report, we present a case of visual hallucinations due to isotretinoin. In our case, with the discontinuation of isotretinoin, the hallucinations regressed and no other cause was found.

Investigation of relapse rate and factors affecting relapse after oral isotretinoin treatment in patients with acne vulgaris.

Oral isotretinoin is the most effective treatment option used in acne treatment. However, varying rates of relapse have been reported after oral isotretinoin therapy. The aim of this study was to evaluate factors that affect relapse after oral isotretinoin treatment in patients with acne. In this cross-sectional study, 212 patients with acne using 0.3-1 mg/kg/day oral isotretinoin for at least 4 months were analyzed retrospectively regarding relapse frequency and factors that affected relapse. In the study, the female-to-male ratio was 3.15, with a mean age of 23.5 ± 6.2 years. The relapse rate was found as 37.3%. The median time to relapse was 10 months. The relapse rate was higher in younger patients (age ≤ 20 years), macrocomedone-type acne, and those with residual lesions at the end of the treatment (p < 0.05 and p < 0.01, respectively). To prevent relapse in patients with acne using oral isotretinoin, it is of great importance to continue the treatment until complete clinical improvement, and extend the treatment for at least one more month regardless of the cumulative dose. Relapse may also occur with younger age and macrocomedone-type acne.

[Social anxiety level in acne vulgaris patients and its relationship to clinical variables]. / Akne vulgaris hastalarinda sosyal kaygi düzeyi ve bunun klinik degiskenler ile iliskisi.

OBJECTIVE: The purpose of this study was to determine the level of social anxiety in acne vulgaris patients and to examine its relationship to the sociodemographic and clinical characteristics of acne, as well as to depression, self-esteem, and negative automatic thoughts. METHOD: The study included 83 acne vulgaris patients from the dermatology outpatient unit of a university hospital and 58 healthy controls. Sociodemographic and clinical questionnaires, and the Global Acne Grading System (GAGS), Hospital Anxiety and Depression Scale (HADS), Liebowitz Social Anxiety Scale (LSAS), Rosenberg Self-Esteem Scale (RSES), and Automatic Thoughts Scale (ATS) were administered to both groups. RESULTS: The degree of social anxiety, social avoidance/withdrawal, general anxiety, depression, and negative automatic thoughts were significantly higher, and self-esteem was significantly lower in the acne patients. Among the 83 patients, scoring above the scales' cut-off points was as follows: 25.6% on the LSAS, 32.9% on the LSAS-Anxiety Subscale, 27.7% on the LSAS-Avoidance Subscale, 36.1% on HADS, 30.1% on the HADS-Depression Subscale, and 50.6% on the HADS-Anxiety Subscale. Psychological symptoms were negatively correlated with age and level of education in the patient group; however no relationship was observed between the psychological symptoms, and gender, the severity of acne, or acne localization. The patients rated their symptoms more severely than did the clinicians; however, the subjective ratings of the patients were not correlated to their psychological symptoms. CONCLUSION: Acne vulgaris must be considered as an illness with the potential to negatively affect the psychological and emotional functioning of patients; therefore, routine psychiatric evaluation and psychological support should be part of the routine acne treatment plan.