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Seborrheic Dermatitis-Like Eruption in Patients Taking Isotretinoin Therapy for Acne

Retrospective Study of Five Patients

  • Original Research Article
  • Isotretinoin-Induced Seborrheic Dermatitis-Like Eruption
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background: Isotretinoin therapy for acne is often associated with mucocutaneous reactions that are usually dose dependent.

Objective: To describe the characteristics of five patients who presented with a peculiar facial rash that developed during or after a successful course of isotretinoin therapy for acne.

Methods: In this retrospective study, five patients who were treated with isotretinoin and who developed, during or following treatment, a peculiar facial eruption that has not previously been reported, are described. The clinical characteristics, laboratory findings, therapy, and course of the eruption are presented.

Results: The rash was characterized by small, yellow, adherent, greasy scales, either flat-topped or spiky, mostly on the cheeks, that resembled seborrheic dermatitis. Cultures obtained in one case grew Staphylococcus coagulase-negative, Acinetobacter, and Pityrosporum ovale organisms. In another patient, microscopic study showed hyperkeratotic scales with many spores and Gram-negative coccobacilli. Topical administration of ointments containing chloramphenicol 3% for 2–3 weeks was curative.

Conclusion: Seborrheic dermatitis-like eruption may be another adverse cutaneous effect of isotretinoin treatment. Its pathogenesis probably involves a minimal toxic retinoid effect on epidermal differentiation with overgrowth of commensal microorganisms in susceptible individuals.

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Acknowledgments

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel, 52621

    Aviv Barzilai & Henri Trau

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Aviv Barzilai, Michael David, Henri Trau & Emmilia Hodak

  3. Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel

    Michael David & Emmilia Hodak

Authors
  1. Aviv Barzilai
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  2. Michael David
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  3. Henri Trau
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  4. Emmilia Hodak
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Correspondence to Aviv Barzilai.

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Barzilai, A., David, M., Trau, H. et al. Seborrheic Dermatitis-Like Eruption in Patients Taking Isotretinoin Therapy for Acne. Am J Clin Dermatol 9, 255–261 (2008). https://doi.org/10.2165/00128071-200809040-00005

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  • DOI: https://doi.org/10.2165/00128071-200809040-00005

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