Conner C S
Drug Intell Clin Pharm. 1984 Apr;18(4):308-9. doi: 10.1177/106002808401800406.
Isotretinoin is remarkably effective in the treatment of severe cystic acne, however, many complications have been observed during treatment and new toxic effects have been reported. Hypertriglyceridemia associated with decreases in high density lipoprotein (HDL) cholesterol has occurred in 25 percent of patients and requires monitoring during treatment. Painful erosions with granulation tissue recently have been reported in patients with severe acne. Other complications have included corneal opacities, pseudotumor cerebri, hypercalcemia, photosensitivity reactions, abnormal liver function tests, and skeletal hyperostosis. Isotretinoin is teratogenic and should be avoided during pregnancy. With the increasing acceptance and use of isotretinoin for cystic acne, as well as related disorders (inflammatory papulopustular acne with scarring, gram-negative folliculitis, and acne rosacea), a reevaluation of isotretinoin aimed at reducing complications is in order. Patient selection criteria and guidelines directed at reducing these complications are presented.
异维A酸在治疗重度囊肿性痤疮方面疗效显著，然而，治疗期间观察到许多并发症，并且有新的毒性作用被报道。25%的患者出现了与高密度脂蛋白（HDL）胆固醇降低相关的高甘油三酯血症，治疗期间需要进行监测。最近有报道称，重度痤疮患者出现了伴有肉芽组织的疼痛性糜烂。其他并发症包括角膜混浊、假性脑瘤、高钙血症、光敏反应、肝功能检查异常和骨骼骨质增生。异维A酸具有致畸性，怀孕期间应避免使用。随着异维A酸在囊肿性痤疮以及相关病症（伴有瘢痕的炎性丘疹脓疱性痤疮、革兰阴性菌毛囊炎和酒渣鼻）治疗中的接受度和使用量不断增加，有必要对异维A酸进行重新评估以减少并发症。本文提出了旨在减少这些并发症的患者选择标准和指导原则。
