Recalcitrant nodulocystic acne in black Americans: treatment with isotretinoin

The beneficial effects of isotretinoin (Accutane) on severe nodulocystic acne and significant clinical improvement with prolonged remission are well documented in the literature; however, the subjects in these clinical studies are invariably white. The purpose of this study was to evaluate the response of black patients with recalcitrant nodulocystic acne to isotretinoin treatment. Ten black patients, ranging in age from 17 to 34 years, were treated for nodulocystic acne with 1 mg/kg/d of isotretinoin for 20 weeks and followed for an additional six months. Of the ten patients, eight adhered to the treatment regimen and were still in remission six months after completion of isotretinoin therapy. The differences and similarities seen between black patients and white patients with nodulocystic acne are discussed.