The Safety of Isotretinoin Treatment in Patients with Peanut Allergies

Isotretinoin, the gold standard treatment for nodulocystic acne vulgaris, is contraindicated in patients with a soy allergy. Due to potential cross-reactivity, a history of peanut allergy is listed as a contraindication to isotretinoin use in some countries.

We sought to further evaluate the safety of isotretinoin use in patients with peanut allergy.

Using Epic's SlicerDicer, patients were identified with both an allergy to peanuts and history of isotretinoin use for treatment of acne vulgaris. Clinical manifestation to peanut exposure, peanut-specific skin prick and/or IgE testing, and adverse reactions to isotretinoin use were recorded via chart review and phone interviews.

Ten patients were identified having both a peanut allergy and treatment for acne vulgaris with isotretinoin. All patients tolerated isotretinoin without evidence of allergy.

Isotretinoin use did not result in allergic eruptions in patients with a known peanut allergy, however, more robust clinical studies are needed to confirm the extent of its use in this patient population.