Manfredini Marco, Bettoli Vincenzo, Forconi Riccardo, Pacetti Lucrezia, Farnetani Francesca, Corazza Monica, Pellacani Giovanni
Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, Dermatology Unit, University of Modena & Reggio Emilia, Modena, Italy.
Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy.
Skin Appendage Disord. 2020 Jun;6(3):142-146. doi: 10.1159/000507455. Epub 2020 May 5.
The value of creatine phosphokinase (CPK) monitoring during isotretinoin therapy is still a matter of debate because of the rarity of muscular and kidney damage in this setting. The aim of the study was to investigate the incidence of CPK elevation during a low starting dose isotretinoin regimen and to discuss the clinical approach to patients with increased CPK.
We reviewed the records of the acne patients from 2015 to 2018 at the University of Ferrara and at the University of Modena and Reggio Emilia. Routine clinical and laboratory follow-up was analyzed.
The records of 328 patients were included in the study. Abnormal CPK levels were observed in 5.5% of cases. Revised Leeds acne scores and visual assessment scale (VAS) measurements decreased significantly after isotretinoin therapy.
The adoption of the low starting dose isotretinoin regimen is associated with low incidence of CPK elevation. The finding of CPK over the conventional value of 5 times above the limit was rarely observed and was never associated with kidney damage. Therefore, it should be interpreted as a relatively benign phenomenon that does not require the interruption of isotretinoin therapy and that should be managed mainly through the reassurance of the patient.
由于在异维A酸治疗期间肌肉和肾脏损伤罕见，因此肌酸磷酸激酶（CPK）监测的价值仍存在争议。本研究的目的是调查低起始剂量异维A酸治疗方案期间CPK升高的发生率，并讨论CPK升高患者的临床处理方法。
我们回顾了费拉拉大学以及摩德纳与雷焦艾米利亚大学2015年至2018年痤疮患者的记录。分析了常规临床和实验室随访情况。
328例患者的记录纳入本研究。5.5%的病例观察到CPK水平异常。异维A酸治疗后，修订的利兹痤疮评分和视觉评估量表（VAS）测量值显著下降。
采用低起始剂量异维A酸治疗方案与CPK升高的低发生率相关。很少观察到CPK超过常规上限值5倍的情况，且从未与肾脏损伤相关。因此，应将其解释为一种相对良性的现象，不需要中断异维A酸治疗，主要应对措施应为安抚患者。
