Alyasi Afnan, Al Hawsawi Khalid, Malebari Bashaer A, Mandili Rasha, Alqasim Dhiyaa
Medicine and Surgery, Umm Al-Qura University, Makkah, SAU.
Department of Dermatology, King Abdulaziz Hospital, Makkah, SAU.
Cureus. 2021 Jul 29;13(7):e16716. doi: 10.7759/cureus.16716. eCollection 2021 Jul.
Isotretinoin is one of the first-line medications for the treatment of acne. One of the reported side effects of isotretinoin is thrombocytopenia, in addition to other abnormalities such as incomplete blood count. However, reports on thrombocytosis associated with isotretinoin are controversial. The present report discusses the case of a patient with acne vulgaris who was treated with isotretinoin and consequently suffered from isotretinoin-induced thrombocytosis. A 20-year-old female patient was diagnosed with acne vulgaris and started treatment with systemic isotretinoin (20 mg once daily) for one month. A baseline complete blood count was performed, as well as another blood count after one month of medication administration. Platelet count was recorded at each visit. The baseline platelet count was within the normal range; however, it was found to be elevated after one month of treatment. Accordingly, the medication was discontinued, and the platelet count returned to normal levels after one month, as measured during the monthly visit. The patient also experienced seizure episodes during treatment, which did not cease with the treatment discontinuation. Although isotretinoin-induced thrombocytosis is considered a rare side-effect for isotretinoin, it should be routinely monitored in high-risk patients and those undergoing surgeries. Further prospective studies on isotretinoin-induced thrombocytosis need to be conducted to gain a deeper insight into the various aspects related to the condition.
异维A酸是治疗痤疮的一线药物之一。异维A酸报告的副作用之一是血小板减少症,此外还有其他异常情况,如全血细胞计数异常。然而,关于异维A酸相关血小板增多症的报道存在争议。本报告讨论了一名寻常痤疮患者的病例,该患者接受异维A酸治疗后出现了异维A酸诱导的血小板增多症。一名20岁女性患者被诊断为寻常痤疮,并开始接受系统性异维A酸治疗(每日一次,每次20毫克),为期一个月。治疗前进行了一次基线全血细胞计数,并在用药一个月后再次进行了血细胞计数。每次就诊时都记录血小板计数。基线血小板计数在正常范围内;然而,治疗一个月后发现血小板计数升高。因此,停药,一个月后的月度就诊时测量发现血小板计数恢复到正常水平。患者在治疗期间还出现了癫痫发作,停药后发作并未停止。虽然异维A酸诱导的血小板增多症被认为是异维A酸罕见的副作用,但对于高危患者和接受手术的患者应常规监测。需要对异维A酸诱导的血小板增多症进行进一步的前瞻性研究,以更深入地了解与该病症相关的各个方面。