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Acne: danger of lesions of the mucous membranes with isotretinoin

In addition to the risk of teratogenic effects, oral isotretinoin can cause adverse effects to the mucous membranes, especially in the stomach.

Not all forms of acne require drug treatment. If necessary, the front-line option is a topical treatment and washing with mild soap and thorough rinsing. Only if topical treatment fails should a systemic treatment be offered, an antibiotic in particular or even isotretinoin.

But caution is required with regard to oral isotretinoin, whose severe teratogenic effects have been well known for a long time.

Isotretinoin also causes a number of other adverse effects, the list of which grows longer with time: skin dryness, irritation and skin fragility, etc. Alterations to the mucous membranes result in a number of disorders of varying severity: ocular (conjunctivitis), ENT (nosebleeds etc.), respiratory, urinary, etc.

Oral isotretinoin also causes or aggravates lesions of the intestine with sometimes severe consequences: diarrhoea with bleeding, inflammation or other various lesions of the entire digestive tract, sometimes resulting in surgery.

Caution demands that patients with a personal or family history of inflammatory intestinal disease should not be exposed to isotretinoin.

©Prescrire April 2008

Source: "Isotrétinoïne et lésions intestinales" Rev Prescrire 2008; 28 (294) 271-273.

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