Abstract

COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF LOW-DOSE ISOTRETINOIN TO STANDARD DOSE ISOTRETINOIN IN MODERATE-TO-SEVERE GRADES OF ACNE VULGARIS

Author(s): Sanjay Nathmal Agrawal, Pranita P. Daware, Bhushan Jairam Telhure

BACKGROUND Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit characterised by comedones, papules, pustules, nodules and cysts, which may later on develop into scarring. This disease occurs worldwide and usually starts in adolescence and resolves in the mid 20s. Initially, isotretinoin was used only for severe grades of acne, but in recent years, this drug has been increasingly prescribed in moderate cases of acne unresponsive to the conventional treatment. Isotretinoin is the most dependable acne treatment and maybe justified in moderate grades of acne where scarring is imminent or acne associated with psychological diseases. Though the recommended dose produces good results, it causes many side effects, cheilitis being most common. To overcome these side effects, lower doses of isotretinoin are being tried in various clinical trials. MATERIALS AND METHODS The study was conducted on 80 patients of acne attending the Outpatient Department of Dermatology at a tertiary care hospital. The patients fulfilling the inclusion and exclusion criteria were enrolled or excluded. The assessment of effectiveness was done using ‘total acne load’ and follow up of patients were done after 2nd, 4th, 8th, 12th week and 16th of initiation of treatment. RESULTS On comparison of group 1 with group 2 with Student’s t-test, p value was 0.10 at 2 weeks of therapy indicating there was no difference between the efficacies of these two treatment groups at 2 weeks. However, the p value calculated for 4 weeks, 8 weeks, 12 weeks and 16 weeks were 0.01, 0.00, 0.00 and 0.00. This indicated that therapy with standard dose was more effective. CONCLUSION The results from this study indicate that on comparing total acne load at end of 16 weeks therapy, low-dose isotretinoin therapy is slightly less in efficacy (87.31%) than standard dose isotretinoin therapy (94.45%), but they are comparable. Taking into account, the side effect profile, they are significantly less in incidence and severity in low-dose therapy than the standard-dose therapy.