The frequency of hematuria in acne vulgaris patients during isotretinoin treatment.

BACKGROUND: Systemic isotretinoin (13-cis-retinoic acid) is effective in the treatment of acne vulgaris. The most common side effects are mucocutaneous ones. Hematuria seen secondary to isotretinoin treatment is thought to be due to mucosal dryness in the urinary system. This study aims to determine the frequency of hematuria in acne vulgaris patients during isotretinoin treatment. MATERIALS AND METHOD: Eighty-eight subjects aged 16-32 years were included in the study group and 52 subjects were in the control group. The subjects were treated for 6 months and were monitored monthly by complete urine analyzes. They were also examined each month in terms of cheilitis, xerosis, epistaxis, rectal bleeding, fatigue, myalgia, weight loss, dry eye, conjunctivitis, headache, dysuria and pollakiuria. RESULTS: In the study group, 15 subjects (17%) had hematuria at least once during the study, and in the control group, four subjects (7.7%) had hematuria. The difference was not statistically significant (p = 0.118). Among the subjects who had hematuria, 11 of them (73.3%) were female and four of them (33.3%) were male in the study group while all the subjects with hematuria in the control group were female. Hematuria and gender did not show a statistically significant correlation. CONCLUSION: Hematuria was observed in 17% of the study group; this frequency rate was not different from that of the normal population. In subjects having isotretinoin treatment, if all the other reasons or disorders are excluded, one must keep in mind that hematuria may be due to isotretinoin use.

Transient postnatal secretion of androgen hormones is associated with acne and sebaceous gland hypertrophy in early infancy.

CONTEXT: Sebaceous gland hypertrophy (SGH) and acne-like skin eruptions are frequent during the first months of life, yet the etiology and prevalence of these conditions in infants are not clear. OBJECTIVE: The objective of the study was to evaluate the association of postnatal androgens with SGH and acne in infants. DESIGN: This was a longitudinal, monthly follow-up from 1 wk (D7) to 6 months of age (M1-M6). PATIENTS: Patients included 54 full-term (FT; 26 boys) and 48 preterm (PT; gestational age at birth 27.7-36.6 wk, 22 boys) infants. MAIN OUTCOME MEASURES: The occurrence of SGH (present/absent) and acne (5-10, 10-50, and >50 papules) was registered and compared with urinary levels of dehydroepiandrosterone and its sulphate and testosterone measured by liquid chromatography-tandem mass spectrometry. RESULTS: SGH was observed in 89% of FT and 96% of PT infants (P = 0.28). Acne (more than five papules) was observed in 91% of FT infants and in 75% of PT infants (P = 0.06). Both SGH and acne were associated with developmental rather than calendar age: SGH was limited to postmenstrual age less than 46 wk and acne was not observed less than 37 wk of postmenstrual age. Urinary androgen levels showed severalfold differences in magnitude between sexes and between the FT and PT groups. After grouping according to sex and maturity, the occurrence of SGH and the severity of acne were associated with higher urinary dehydroepiandrosterone sulphate and testosterone levels in each group. CONCLUSIONS: SGH and acne are common during the first months of life and associated with endogenous, physiologically elevated levels of androgens originating from the adrenals and gonads. These data suggest a novel role for postnatal androgen secretion in infancy.

Is it necessary to have routine blood tests in patients treated with isotretinoin?

OBJECTIVES: Several side effects can be observed from isotretinoin use, which has been used in acne therapy for years. In this study, the side effects of isotretinoin on skin and mucosa, blood test changes and their relation with total dose were investigated in patients who used equal doses of isotretinoin. MATERIALS AND METHODS: A total of 91 outpatients with acne vulgaris (57 females and 34 males; age range 17-28 years, mean 21+/-2.19 years) were enrolled in this study. Skin and mucosal findings and pre- and post-treatment blood tests and their correlation with the total dose were investigated. Student's t-test and the Mann-Whitney U-test were used in the statistical analyses. RESULTS: In all, 89 out of 91 patients completed the study. Cholesterol (p = 0.00), triglyceride (p = 0.00) and low density lipoprotein (LDL) (p = 0.001) levels were found to be significantly elevated. But these values were not over the double of the upper limits. No correlations were found among the total dose and the skin and mucosal changes as well as the blood test results. CONCLUSION: It is concluded that examination of cholesterol, triglyceride and LDL-cholesterol should be performed monthly if the initial blood tests are close to the upper limits; otherwise, examinations at 2- or 3-month intervals are sufficient, which would save unnecessary costs.

Chloracne and morbidity after dioxin exposure (preliminary results).

In this paper, 159 cases of chloracne contamination, reported from 1969 to 1975, in TCDD-contaminated production of the herbicide 2,4,5-trichlorophenol (2,4,5-T) were followed for mortality and morbidity up to 1996, when blood and urine tests were performed on 50 of these chemical workers ('exposed') and matched controls. In exposed workers, the most frequent cause of sick leave was chloracne, which persisted in 32%. Neurological symptoms were reported frequently (44% sleep disturbance, 32% headache, 30% neuralgia). BSR, leucocytes, gamma-GT, S-G0T and S-GPT were significantly higher than in controls. The effects of exposure (P = 0.002) and alcohol (P = 0.002) on gamma-GT were found to be independent of each other.

A health survey of workers in the pentachlorophenol section of a chemical manufacturing plant.

During 1968 to 1985, 109 workers who had been engaged in the production of pentachlorophenol, using non-gamma isomers of hexachloroclohexane (BHC) as the raw material, were surveyed. Endemic chloracne among them had been noted since 1974. The prevalence of chloracne was 73.4% (80/109) in total and 95.2% (20/21) in a trichlorobenzene (TCB) tank area where dioxin and dibenzofurans levels were thousands of ppm. To our knowledge, PCDDs and PCDFs have not previously been reported from thermal decomposition of BHC. Urinary porphyrins were significantly higher among exposed workers than among the controls but there was no significant difference between the workers with chloracne and those without. The conduction velocities of the median motor nerves were much slower among the workers in the TCB tank area where the highest PCDDs contamination appeared. The mortality study cohort was relatively young. Based on the three deaths observed during the follow-up, no association could be drawn.