Teratogenic Potential of Isotretinoin

1986 ◽  
Vol 8 (3) ◽  
pp. 68-94
Keyword(s):  
Animal Models ◽  
Vitamin A ◽  
Premature Infant ◽  
Congenital Anomalies ◽  
Pharmacologic Therapy ◽  
Multiple Congenital Anomalies ◽  
Keratolytic Agents ◽  
Teratogenic Potential ◽  
Vitamin A Derivative ◽  
Systemic Antibiotics

Pharmacologic therapy for acne, for the most part, consists of topical keratolytic agents and systemic antibiotics, but these modalities have had very little success in the treatment of cystic acne. In September 1982, isotretinoin, a Vitamin A derivative, was marketed for the treatment of recalcitrant acne and has proven to be efficacious. Because of the known teratogenicity of vitamin A in animal models, a manufacturer's warning was issued advising patients not to take this medication if they were pregnant or intended to become pregnant. Despite these warnings, there are reported cases of multiple congenital anomalies in infants born to mothers who took isotretinoin during the first half of pregnancy. Among the reported cases is a premature infant of 30 weeks' gestation born to a 22-year-old woman who used isotretinoin during her first 2 months of pregnancy.

Retinoid Therapy for Severe Dermatological Disorders

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 119-120
Author(s):  
Keyword(s):  
Retinoic Acid ◽  
Severe Psoriasis ◽  
Childbearing Age ◽  
Systemic Corticosteroids ◽  
All Trans Retinoic Acid ◽  
Uva Light ◽  
Dermatological Disorders ◽  
Teratogenic Potential ◽  
Vitamin A Derivative ◽  
Systemic Antibiotics

Isotretinoin is approved for the treatment of severe recalcitrant cystic acne, and etretinate is approved for the treatment of severe recalcitrant psoriasis. Women of childbearing age place their infants at risk should these compounds be used during pregnancy and, in the case of etretinate, even before pregnancy. The purpose of this statement is to describe the indications for the use of these drugs and to advise physicians of their common side effects and their teratogenic potential. Isotretinoin, 13-cis-retinoic acid (Accutane, Hoffmann-LaRoche), is a vitamin A derivative that is effective in the treatment of severe cystic acne. This type of acne, affecting adolescents and young adults, is severe, nodular, cystic, and conglobate—a scarring disease that resists treatment with topical or systemic antibiotics, benzoyl peroxide, all-trans-retinoic acid, and intralesional corticosteroids. Adolescents with less severe forms of acne who learn about the therapeutic triumphs of isotretinoin in severe recalcitrant nodular and cystic acne may assume that the drug also would be beneficial for them. Physicians should explain to these adolescents why isotretinoin is not indicated in the treatment of typical acne. Another retinoid, etretinate (Tegison, Hoffmann-La Roche), is now available for the treatment of severe psoriasis that is unresponsive to standard therapies (topical tar with UVB light, anthralin, UVA light and psoralens, systemic corticosteroids and methotrexate). Etretinate is used for severe psoriasis of both the erythrodermic and generalized pustular types. Individualization of etretinate dosage is important. Most patients are started at a dosage of 0.75 to 1.0 mg/kg of body weight per day in divided doses.

Multiple congenital anomalies associated with apparently normal maternal intake of vitamin A: A phenocopy of the isotretinoin syndrome?

1987 ◽  
Vol 27 (2) ◽  
pp. 245-248 ◽  
Author(s):  
M. S. Lungarotti ◽  
D. Marinelli ◽  
T. Mariani ◽  
A. Calabro ◽  
John M. Opitz ◽  
...  
Keyword(s):  
Vitamin A ◽  
Congenital Anomalies ◽  
Multiple Congenital Anomalies

Cloverleaf skull and multiple congenital anomalies in a girl exposed to cocaine in utero: case report and review of the literature

2000 ◽  
Vol 16 (3) ◽  
pp. 0176 ◽  
Author(s):  
M. C. Esmer ◽  
G. Rodriguez-Soto ◽  
D. Carrasco-Daza ◽  
M. L. Iracheta ◽  
V. Del Castillo
Keyword(s):  
Case Report ◽  
Congenital Anomalies ◽  
In Utero ◽  
Review Of The Literature ◽  
Multiple Congenital Anomalies ◽  
Cloverleaf Skull

Monitoring for new multiple congenital anomalies in the search for human teratogens

1993 ◽  
Vol 46 (4) ◽  
pp. 460-466 ◽  
Author(s):  
Muin J. Khoury ◽  
Lorenzo Botto ◽  
Grady D. Waters ◽  
Pierpaolo Mastroiacovo ◽  
Eduardo Castilla ◽  
...  
Keyword(s):  
Congenital Anomalies ◽  
Multiple Congenital Anomalies
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