Preliminary observations on isotretinoin-induced ear malformations and pattern formation of the external ear

Retinoic acid is a morphogenic substance capable of inducing a variety of limb malformations, including duplications and reduction-type defects. Whether retinoic acid plays a similar role in controlling pattern formation of other vertebrate structures is unclear. Many fetuses and infants exposed to isotretinoin (13-cis-retinoic acid) in utero have a characteristic pattern of anomalies, chiefly involving brain, craniofacial, and thymic morphogenesis. Among the craniofacial anomalies, external ear malformations are common and the specific types of auricular malformations include partial duplications, and tissue reductions and displacements. These similarities to the types of limb malformations that retinoic acid can induce suggest that retinoic acid may play an important role in controlling pattern formation of facial structures.