Nail changes in patients receiving systemic isotretinoin therapy.
Cumulative dose
Isotretinoin
Nail disorders
Onychoschizia
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
26 Oct 2024
26 Oct 2024
Historique:
received:
03
05
2024
accepted:
21
10
2024
medline:
27
10
2024
pubmed:
27
10
2024
entrez:
27
10
2024
Statut:
epublish
Résumé
In this study, it was aimed to describe isotretinoin-induced nail changes and increase patients' treatment compliance. A total of 200 patients diagnosed with acne vulgaris were included in the study. 100 of the patients were started systemic isotretinoin treatment and 100 control patients were receiving topical acne treatment. Age and gender of all of the participants, duration of treatment, total doses per month, and type of nail changes were recorded. Patients with persistent nail changes were followed at the 3rd and 6th months after treatment. A total of 34 patients had nail changes in the isotretinoin group. These changes included onychoschizia (55.9%), leukonychia (11.8%), onychorexis (8.8%), median nail dystrophy (5.9%), pyogenic granulomas (5.9%), chronic paronychia and granulation tissue (5.9%), onycholysis (2.9%) and Beau's line (2.9%). The rate of nail changes in the isotretinoin group was significantly higher than in the topical treatment group (34% vs. 11%, p:0.001). Isotretinoin increases the risk of nail changes, primarily onychoschizia. The risk of developing nail changes is not associated with treatment duration but is associated with the total cumulative dose. Nail findings induced by isotretinoin are completely reversible.
Identifiants
pubmed: 39462059
doi: 10.1038/s41598-024-77185-0
pii: 10.1038/s41598-024-77185-0
doi:
Substances chimiques
Isotretinoin
EH28UP18IF
Dermatologic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
25561Informations de copyright
© 2024. The Author(s).
Références
Goulden, V., Layton, A. M. & Cunliffe, W. J. Current indications for isotretinoin as a treatment for acne vulgaris. Dermatology. 190, 284–287. https://doi.org/10.1159/000246717 (1995).
doi: 10.1159/000246717
pubmed: 7655106
Vallerand, I. A. et al. Efficacy and adverse events of oral isotretinoin for acne: A systematic review. Br. J. Dermatol. 178, 76–85. https://doi.org/10.1111/bjd.15668 (2018).
doi: 10.1111/bjd.15668
pubmed: 28542914
Ellis, C. N. & Krach, K. J. Uses and complications of isotretinoin therapy. J. Am. Acad. Dermatol. 45, 150–157. https://doi.org/10.1067/mjd.2001.113717 (2001).
doi: 10.1067/mjd.2001.113717
Elias, P. M. Retinoid effects on the epidermis. Dermatologica. 175(Suppl 1), 28–36 https://doi.org/10.1159/000248851 (1987).
Ozcelik, S. & Kilic, F. A. Effects of isotretinoin on the growth rate and thickness of the nail plate. Int. J. Dermatol. 60, 1258–1262. https://doi.org/10.1111/ijd.15635 (2021).
doi: 10.1111/ijd.15635
pubmed: 33950558
Piraccini, B. M. & Iorizzo, M. Drug reactions affecting the nail unit: diagnosis and management. Dermatol. Clin. 25, 215 – 21, vii. https://doi.org/10.1016/j.det.2007.01.006 (2007).
Chen, H. et al. Magnitude and temporal trend of acne vulgaris burden in 204 countries and territories from 1990 to 2019: An analysis from the global burden of disease study 2019. Br. J. Dermatol. 186, 673–683. https://doi.org/10.1111/bjd.20882 (2022).
doi: 10.1111/bjd.20882
pubmed: 34758111
Zaenglein, A. L. et al. Guidelines of care for the management of acne vulgaris. J. Am. Acad. Dermatol. 74, 945 – 73 e3. https://doi.org/10.1016/j.jaad.2015.12.037 (2016).
Baran, R. Therapeutic assessment and side-effects of the aromatic retinoid on the nail apparatus. Ann. Dermatol. Venereol. 109, 367–371 (1982).
pubmed: 7125489
Allegue, F., Gonzalez-Vilas, D. & Zulaica, A. Isotretinoin-induced elkonyxis Actas Dermosifiliogr. 108, 166–167. https://doi.org/10.1016/j.ad.2016.08.007 (2017).
Alli, N. & Dogan, S. Short-term isotretinoin-induced elkonyxis and median nail dystrophy. Cutan. Ocul Toxicol. 35, 85–86. https://doi.org/10.3109/15569527.2014.902380 (2016).
doi: 10.3109/15569527.2014.902380
pubmed: 25799213
Armstrong, K. & Weinstein, M. Pyogenic granulomas during isotretinoin therapy. J. Dermatol. Case Rep. 5, 5–7. https://doi.org/10.3315/jdcr.2011.1062 (2011).
doi: 10.3315/jdcr.2011.1062
pubmed: 21886758
pmcid: 3163353
Benedetto, C., Crasto, D., Ettefagh, L. & Nami, N. Development of periungual pyogenic granuloma with associated paronychia following isotretinoin therapy: A case report and a review of the literature. J. Clin. Aesthet. Dermatol. 12, 32–36 (2019).
pubmed: 31119008
pmcid: 6508482
Bottomley, W. W. & Cunliffe, W. J. Median nail dystrophy associated with isotretinoin therapy. Br. J. Dermatol. 127, 447–448. https://doi.org/10.1111/j.1365-2133.1992.tb00472.x (1992).
doi: 10.1111/j.1365-2133.1992.tb00472.x
pubmed: 1419771
Figueiras Dde, A., Ramos, T. B., Marinho, A. K., Bezerra, M. S. & Cauas, R. C. Paronychia and granulation tissue formation during treatment with isotretinoin. Bras. Dermatol. 91, 223–225. https://doi.org/10.1590/abd1806-4841.20163817 (2016).
doi: 10.1590/abd1806-4841.20163817
Gregoriou, S., Banaka, F. & Rigopoulos, D. Isotretinoin-induced transverse leuconychia. J. Eur. Acad. Dermatol. Venereol. 30, 385–386. https://doi.org/10.1111/jdv.12819 (2016).
doi: 10.1111/jdv.12819
pubmed: 25354039
Onder, M., Oztas, M. O. & Oztas, P. Isotretinoin-induced nail fragility and onycholysis. J. Dermatolog Treat. 12, 115–116. https://doi.org/10.1080/095466301317085426 (2001).
doi: 10.1080/095466301317085426
pubmed: 12243670
Yung, A., Johnson, P. & Goodfield, M. J. Isotretinoin-induced elkonyxis. Br. J. Dermatol. 153, 671–672. https://doi.org/10.1111/j.1365-2133.2005.06782.x (2005).
doi: 10.1111/j.1365-2133.2005.06782.x
pubmed: 16120167
Brzezinski, P., Borowska, K., Chiriac, A. & Smigielski, J. Adverse effects of isotretinoin: A large, retrospective review. Dermatol. Ther. 30. https://doi.org/10.1111/dth.12483 (2017).
Blasiak, R. C., Stamey, C. R., Burkhart, C. N., Lugo-Somolinos, A. & Morrell, D. S. High-dose isotretinoin treatment and the rate of retrial, relapse, and adverse effects in patients with acne vulgaris. JAMA Dermatol. 149, 1392–1398. https://doi.org/10.1001/jamadermatol.2013.6746 (2013).
doi: 10.1001/jamadermatol.2013.6746
pubmed: 24173086
Brito Mde, F., Sant’Anna, I. P., Galindo, J. C., Rosendo, L. H. & Santos, J. B. Evaluation of clinical adverse effects and laboratory alterations in patients with acne vulgaris treated with oral isotretinoin. Bras. Dermatol. 85, 331–337. https://doi.org/10.1590/s0365-05962010000300006 (2010).
doi: 10.1590/s0365-05962010000300006
Rademaker, M. Adverse effects of isotretinoin: A retrospective review of 1743 patients started on isotretinoin. Australas J. Dermatol. 51, 248–253. https://doi.org/10.1111/j.1440-0960.2010.00657.x (2010).
doi: 10.1111/j.1440-0960.2010.00657.x
pubmed: 21198520
Demirseren, D. D. et al. The weeks and the cumulative doses of the first adverse events related to oral isotretinoin in acne patients: Analysis of 300 patients. J. Dermatol. Treat. 28, 309–313. https://doi.org/10.1080/09546634.2016.1230175 (2017).
doi: 10.1080/09546634.2016.1230175
Legiawati, L., Fahira, A., Taufiqqurrachman, I., Arifin, G. R. & Widitha, U. R. Low-dose versus conventional-dose oral isotretinoin regimens: A systematic review on randomized controlled comparative studies of different regimens. Curr. Drug Saf. 18, 297–306. https://doi.org/10.2174/1574886317666220613162225 (2023).
doi: 10.2174/1574886317666220613162225
pubmed: 35702787
Goulden, V., Layton, A. M. & Cunliffe, W. J. Long-term safety of isotretinoin as a treatment for acne vulgaris. Br. J. Dermatol. 131, 360–363. https://doi.org/10.1111/j.1365-2133.1994.tb08524.x (1994).
doi: 10.1111/j.1365-2133.1994.tb08524.x
pubmed: 7918010