PubMed · 138561
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R J Coskey. 1976. Dermatologic therapy: 1975.. https://pubmed.ncbi.nlm.nih.gov/138561/
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Primary care physicians should be familiar with the effects and appropriate uses of retinoids. Topical tretinoin (Retin-A) can reverse photoaging of the skin, although some transient, undesirable side effects usually occur. In patients with acne vulgaris, topical tretinoin and systemic isotretinoin (Accutane) are the only agents that act upon the apparent underlying causes. Recurrence is unlikely after successful results are achieved. Chronic hypervitaminosis A presents insidiously, and physicians must maintain a high index of suspicion. Complete history taking should always include questions about the patient's use of vitamin supplements.
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Twenty patients (21.4 +/- 4.3 years) with extensive acne conglobata affecting the face, chest and back, were treated for a period of six months with isotretinoin (13-cis retinoic acid, 13-cis RA) at a dosage of 1 mg/kg body weight/day (mean daily dose 72.7 +/- 9.8 mg 13-cis RA). In all cases, the acne conglobata cleared up completely. With the exception of symptoms produced by mucocutaneous exsiccation, no side effects were observed; the laboratory parameters were all within normal limits during the anti-acne treatment phase. There was no recurrence of the disease within a period of one year after cessation of treatment (n = 13). Screening spermatograms performed at two-month intervals during the treatment phase revealed, from the fourth month of treatment onward, a statistically significant increase in the mean sperm density with sperm morphology and motility unchanged as compared with the situation prior to treatment. One year after conclusion of treatment, all measured spermatogram parameters had returned to the initial values. The investigations revealed no evidence of any negative influence of the 6-month treatment with isotretinoin on spermatogenesis.