Chelliah Priya, Glass Donald
University of Texas Southwestern Medical Center, Dallas, TX, United States.
Int J Womens Dermatol. 2020 Jul 17;6(5):365-367. doi: 10.1016/j.ijwd.2020.07.004. eCollection 2020 Dec.
In 1982, oral isotretinoin was first licensed as a treatment option for severe recalcitrant cystic acne in the United States. Since its introduction into the pharmaceutical market, several instances of amenorrhea in women of child-bearing age taking isotretinoin have been reported. In each documented instance, amenorrhea spontaneously resolved once the medication was discontinued. The Patient Introductory Brochure for iPLEDGE, the risk management distribution program mandated by the U.S. Food and Drug Administration for isotretinoin, does not currently include menstrual irregularities as a side effect of treatment; thus, patients who experience this side effect may also experience the unnecessary stress of a possible pregnancy, or, if a minor, explaining a lack of menses to their parent/guardian. This review synthesizes the limited literature available on this subject to advocate for more widespread acknowledgment of menstrual irregularities as a side effect of isotretinoin therapy. To perform the literature review, the search was conducted on June 13, 2020 on PubMed using the following search terms: (((isotretinoin) AND (oligomenorrhea))) OR ((isotretinoin) AND (amenorrhea)) OR ((isotretinoin) AND (PCOS)) OR ((isotretinoin) AND (menstrual irregularities)) OR ((isotretinoin) AND (polycystic ovary syndrome)). All years available were included. Articles were excluded if they were not published in English or did not address the topic of menstrual irregularities in the setting of isotretinoin, with or without the presence of polycystic ovary syndrome. A total of six articles met our criteria and are described.
1982年，口服异维A酸在美国首次被批准作为重度顽固性囊肿性痤疮的一种治疗选择。自其进入药品市场以来，已有多例服用异维A酸的育龄女性出现闭经的报道。在每一例有记录的病例中，停药后闭经均自行缓解。美国食品药品监督管理局强制要求的异维A酸风险管理分发项目iPLEDGE的患者介绍手册目前并未将月经不调列为治疗的副作用；因此，出现这种副作用的患者可能还会经历可能怀孕带来的不必要压力，或者，如果是未成年人，要向其父母/监护人解释月经不来的情况。这篇综述综合了关于该主题的有限文献，以倡导更广泛地承认月经不调是异维A酸治疗的副作用。为进行文献综述，于2020年6月13日在PubMed上使用以下检索词进行检索：(((异维A酸) AND (月经过少))) OR ((异维A酸) AND (闭经)) OR ((异维A酸) AND (多囊卵巢综合征)) OR ((异维A酸) AND (月经不调)) OR ((异维A酸) AND (多囊卵巢综合征))。纳入所有年份的文献。如果文章不是用英文发表的，或者没有涉及异维A酸背景下月经不调的主题，无论是否伴有多囊卵巢综合征，均予以排除。共有6篇文章符合我们的标准并在此进行描述。
