Recurrence of acne after treatment with systemic isotretinoin: causes and methods of prevention
- 作者: Tlish M.M.1, Shavilova M.E.1
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隶属关系:
- Kuban State Medical University
- 期: 卷 100, 编号 6 (2024)
- 页面: 92-100
- 栏目: CLINICAL CASE REPORTS
- URL: https://ogarev-online.ru/0042-4609/article/view/279237
- DOI: https://doi.org/10.25208/vdv16809
- ID: 279237
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Isotretinoin is an effective drug for the treatment of patients with severe forms of acne, which has been proven in a large number of studies and is enshrined in the clinical recommendations of dermatological communities in various countries. Despite this, the multifactorial etiology and complex pathophysiological processes of acne development determine the risk of relapse of the disease. Determining prognostic factors for exacerbation of acne after isotretinoin therapy is a significant problem that has been actively discussed in scientific publications in recent years. The article focuses on the fact that the effectiveness of isotretinoin in patients with acne depends both on a competent treatment strategy and on the characteristics of the course of the disease (genetic burden, comorbid pathology), which are individual for each patient. An analysis of our own clinical observations of patients with acne, in whom relapses of the disease were the result of either an incorrect dosage regimen of the drug, or the lack of correction of concomitant pathology, or an early onset and initially severe course of dermatosis, is provided. It is noted that a personalized approach to the management of such patients and the prevention of factors that provoke relapse allow the doctor and patient to form realistic expectations from isotretinoin therapy, increase its effectiveness and reduce the likelihood of disease progression.
作者简介
Marina Tlish
Kuban State Medical University
Email: marina@netzkom.ru
ORCID iD: 0000-0001-9323-4604
SPIN 代码: 8452-4062
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, 4 Mitrofana Sedina street, 350063 KrasnodarMarina Shavilova
Kuban State Medical University
编辑信件的主要联系方式.
Email: marina@netzkom.ru
ORCID iD: 0000-0002-5776-6221
SPIN 代码: 3346-6060
MD, Cand. Sci. (Med.)
俄罗斯联邦, 4 Mitrofana Sedina street, 350063 Krasnodar参考
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Fig. 1. Patient A., severe papulopustular acne accompanied by concomitant polycystic ovary syndrome. Dynamics of the skin pathological process: a — before the start of therapy; б — on the 5th month of therapy
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Fig. 2. Patient K., severe papulopustular acne accompanied by concomitant constitutional exogenous obesity and impaired glucose tolerance. Dynamics of the skin pathological process: a — before the start of therapy, б — at the 10th month of therapy
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Fig. 3. Patient I., excoriated papulopustular acne of moderate severity, relapse after a course of isotretinoin against the background of obsessive-compulsive disorder with self-harm of the skin and he absence of maintenance therapy: a — before the start of therapy, б — on the 2rd month of therapy
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