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Published on: November 1, 2024
A practical approach for the use of oral isotretinoin for infantile acne
Cheryl J Barnes1, Lawrence F Eichenfield, Jungho Lee
1Division of Pediatric and Adolescent Dermatology, Department of Pediatrics, University of California San Diego, San Diego, California 92123, USA.
Insights
Infantile cystic acne, a rare condition in infants, can be effectively treated with oral isotretinoin. This study details successful treatment protocols and emphasizes careful monitoring for potential side effects.
Area of Science:
- Pediatric Dermatology
- Dermatology
- Neonatology
Background:
- Infantile acne is a rare skin condition affecting infants aged 1-16 months, predominantly in males.
- Lesions can manifest as comedones, papulopustules, or cysts, posing a therapeutic challenge.
- Existing treatments include topical agents and antibiotics, but severe cases may require alternative approaches.
Observation:
- This study reports on two infants diagnosed with recalcitrant infantile cystic acne.
- Both patients were successfully treated with oral isotretinoin, a medication typically reserved for severe cases.
- Treatment dosages ranged from 0.2 to 1.5 mg/kg/day over 5 to 14 months.
Findings:
- Oral isotretinoin demonstrated significant efficacy in resolving severe infantile cystic acne in the presented cases.
- The therapeutic response was observed across a spectrum of dosages and treatment durations.
- No adverse events were detailed, but monthly monitoring is advised due to known isotretinoin side effects.
Implications:
- Oral isotretinoin offers a viable treatment option for severe infantile cystic acne unresponsive to conventional therapies.
- Further research into optimal dosing and long-term outcomes of isotretinoin in infants is warranted.
- Clinical guidelines may benefit from incorporating oral isotretinoin for recalcitrant infantile acne cases, with strict patient monitoring.
Abstract:
Infantile acne is a rare occurrence. It is more common in boys and predominately occurs on the cheeks in infants between the ages of 1 and 16 months. Clinically, the lesions range from comedones to inflammatory papulopustules to cysts. Successful therapies include topical tretinoin, benzoyl peroxide and topical and oral erythromycin. For more serious cases, oral isotretinoin (Accutane) has been reported to successfully treat recalcitrant infantile cystic acne. We describe two additional patients with infantile cystic acne treated successfully with oral isotretinoin. The dose of isotretinoin used ranged from 0.2 mg/kg/day to 1.5 mg/kg/day. The treatment duration varied from 5 to 14 months. Careful monthly monitoring is recommended because of the many side effects reported with isotretinoin. Practical tips for the administration of oral isotretinoin in infants are reviewed.
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