Evaluation of the prevalence and etiology of headache in acne patient during treatment by oral Isotretinoin (Roaccutane)
Dr Anahita Vali,Dr Farzad Izadi
Introduction: oral Isotretinoin is the most effective treatment of nodulocystic acne but it may cause some side effects such as elevation of serum triglyceride & cholesterol level, teratogenicity, rise in liver enzymes, headache, etc. The aim of this study was evaluating prevalence & etiology of headache in acne patients treated by systemic Isotretinoin.
Patients & methods: In this prospective descriptive study 120 patients with nodulocystic acne or chronic acne resistant to other treatment modalities were treated with 30mg Isotretinoin (Ro-accutan) daily until maximum dose 120mg/kg with 20 mg capsules from Roche company . Patients complained from headache referred to a neurologist who evaluate them by taking history, physical & neurologic exam, ophthalmoscopy and if indicated by brain MRI or CT scan.
Results: 14 patients (11.67%) complained from headache during treatment period; 11 female (78.57%) &3 male (21.42%).They were 17-35 years old. Eight patients (66.67%) had history of migraine attacks that increased in frequency and severity during Roaccutane consumption. Six patients had characteristic criteria of migranous headache. Neurologic exam was doubtful in two patients therefore brains MRI were requested. Both of them were normal. Ophthalmoscopy was normal in all 14 cases and evidence of raised intracranial pressure was not seen. Headache sufferers were treated by prophylactic drugs of migraine.13 cases (92.85%) had acceptable response to treatment. only one patient (7.21%) had insufficient response to treatment result in Roaccutane discontinuation.
Conclusion: Study results showed that malignant headache with raised intracranial pressure during Isotretinoin treatment is rare side effect and patients with severe acne and history of tension or migraine headache should not deprive from Isotretinoin.
Key words: oral Isotretinoin, Headache, Nodulocystic acne, Migraine
آدرس مطب : اصفهان ، خیابان فیض ، ابتدای خیابان ارباب
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