Katarzyna Borowska

Adverse effects of isotretinoin: A large, retrospective review

Acne is a very common and disfiguring disease that affects mostly adolescents and, to some extent, adults. The objective of our study was to estimate the adverse effects after isotretinoin by treatment of 3,525 patients due to acne vulgaris in a 5‐year observation. Retrospective, comparative study was carried out in Poland and Romania from January 2012 to August 2016. Inclusion criteria into this study were moderate, severe, and nodulocystic inflammatory acne vulgaris. Exclusion criteria were mild acne, pregnant, and lactating women. Statistical analysis was carried out using T test and Chi square. All patients were treated with oral isotretinoin. Patient age ranged from 13‐35 years. Dry lips was the most commonly reported adverse effect, affecting 100% of users, followed by xerosis (94.97%) and facial erythema (66.21%). Of all adverse effects, psychiatric symptoms accounted for 25.16%; eye lesions accounted for 8.96%. In lab investigations an increase in the level of total cholesterol and serum triglycerides was observed. This study documents the adverse effect profile of isotretinoin in a large number of patients collected over a period of 4 years. Side effects were mild and well tolerated and did not necessitate stopping the treatment. However, it is important to educate patients about this potential consequence.

Possible advantage of imiquimod and diphenylcyclopropenone combined treatment versus diphenylcyclopropenone alone: An observational study of nonresponder patients with alopecia areata

The topical contact sensitiser diphenylcyclopropenone (DCP) remains one of the most effective treatment modalities for alopecia areata (AA). However, some patients (nonresponders) do not respond to this treatment because they do not have an allergic reaction to DCP. The aim of this study was to investigate the potential role of imiquimod in inducing an allergic reaction to DCP in nonresponders. In all, 20 nonresponders were recruited from a group of DCP‐treated AA patients. Of these patients, 10 were treated with DCP and topical imiquimod and 10 were treated with DCP alone. A significantly better therapeutic outcome was measured in the DCP plus imiquimod group than in the group treated with DCP alone. The potential mechanism of imiquimod may involve the role of interleukin‐12, as previously suggested in an animal model. These findings suggest that imiquimod may have the potential to improve prognosis in nonresponder AA patients treated with DCP.

Unusual acne conglobata case mimicking cervicofacial actinomycosis: A case report with literature review

Actinomycosis is a bacterial infection caused by Gram positive, anaerobic or microaerophilic bacilli, Actinomyces spp. These are higher prokaryotic bacteria belonging to the family Actinomyceataceae. The most frequent pathogen species encountered is Actinomyces israelii [1] but many different species have been described and are associated with pathogenic conditions specific to anatomical sites [2,3]. Based on the site affected, actinomycosis is clinically classified into cervicofacial, pulmonothoracic and abdominocervical forms, of which the most common form is cervicofacial. Cervicofacial actinomycotic lesions usually present as single or multiple cysts and abscesses or indurated lumps with fistulation and a discharge of sulfur granules [4]. While acne vulgaris is a very common disease, the cases of actinomycosis are relatively rare.