DeLuca Matthew, Nuñez Maxsaya Baez, Rodriguez Ezequiel, Chirimunj Krishan
St. George's University School of Medicine, True Blue, WI, Grenada.
Department of Psychiatry, Bergen New Bridge Medical Center, 230 E Ridgewood Ave, Paramus, NJ 07652, USA.
Case Rep Psychiatry. 2021 Jul 9;2021:9942327. doi: 10.1155/2021/9942327. eCollection 2021.
We relay the case of a teenage female with severe facial acne vulgaris and a past psychiatric history of major depressive disorder who presented to the emergency department with a primary complaint of ongoing suicidal ideation. Defining features of this case stem from the patient endorsing that her suicidal ideation was a result of her severe acne and the coinciding social perturbation it caused. Additionally, the patient reported that just four months prior to the current presentation, her dermatologist started her on isotretinoin therapy for the management of acne vulgaris. To the best of the authors' knowledge, there have been no reported cases which describe a teenage female presenting with active suicidal ideation secondary to severe acne vulgaris while concurrently undergoing treatment with isotretinoin. Given the controversial but reported association between isotretinoin and increased suicidality, we considered the appropriateness of continuing this medication for our patient. We then conducted a literature search evaluating the evidence concerning this association. In what follows, we present a unique case report and provide a thorough review of the evidence-or lack thereof-surrounding the relationship between isotretinoin and suicidality. Additionally, the authors aim to provide recommendations for the management of future patients who may present under similar circumstances.
我们讲述了一名患有重度寻常性面部痤疮的青少年女性病例，她有重度抑郁症的既往精神病史，因持续存在自杀念头为主诉前来急诊科就诊。该病例的显著特征源于患者认可其自杀念头是由严重痤疮及其引发的社会困扰所致。此外，患者报告称，就在此次就诊前四个月，她的皮肤科医生开始让她服用异维A酸治疗寻常性痤疮。据作者所知，尚无报告病例描述青少年女性在重度寻常性痤疮且同时接受异维A酸治疗的情况下出现主动自杀念头。鉴于异维A酸与自杀倾向增加之间存在有争议但已被报道的关联，我们考虑了继续为我们的患者使用这种药物是否合适。然后我们进行了文献检索，评估有关这种关联的证据。接下来，我们呈现一份独特的病例报告，并对围绕异维A酸与自杀倾向之间关系的现有证据（或缺乏证据的情况）进行全面综述。此外，作者旨在为未来可能在类似情况下就诊的患者的管理提供建议。
