Hyperimmunoglobulin E syndrome: treatment with isotretinoin

A patient with hyperimmunoglobulin E syndrome is described. Recurrent cutaneous staphylococcal abscesses were a prominent feature and had been resistant to treatment with antibiotics and surgical drainage. Following a 4-month course of treatment with isotretinoin, he developed no further abscesses over a 6-month follow-up period. Detailed immunological investigations were undertaken before and after treatment and no change was found to account for his improvement. We consider that the beneficial effects of isotretinoin in this situation are likely to be due to a reduction in sebaceous gland size and activity, rather than to any effect on the underlying disorder.