Isotretinoin ingestion in a pediatric patient

Isotretinoin (13-cis-retinoic acid) is an oral synthetic vitamin A derivative used for control of acne and a variety of other dermatologic conditions. The case of a 21 month old child who accidentally ingested an estimated 1120 mg (63.3 mg/kg) of isotretinoin is presented. The patient demonstrated only minor immediate effects, consisting of facial flushing, and mild tachycardia, tachypnea, and hypertension, all of which resolved over 24 hours. The patient had no subsequent adverse long-term effects from the ingestion. This is the first reported ingestion of isotretinoin in a child. Short term sequelae have not been reported; long-term administration of isotretinoin may cause multiple and potentially severe reactions.