Low-dose oral isotretinoin versus topical retinoic acid for photoaging: a randomized, comparative study

Low-dose oral isotretinoin versus topical retinoic acid for photoaging: a randomized, comparative study

Author Bagatin, Edileia Autor UNIFESP Google Scholar
Guadanhim, Lilia R. S. Autor UNIFESP Google Scholar
Enokihara, Milvia M. S. S. Autor UNIFESP Google Scholar
Sanudo, Adriana Autor UNIFESP Google Scholar
Talarico, Sergio Autor UNIFESP Google Scholar
Miot, Helio A. Autor UNIFESP Google Scholar
Gibson, Lawrence Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract BackgroundOral isotretinoin (ISO) is the only drug which promotes prolonged remission or cure of severe acne. It also has other properties, supporting its use for non-acne indications. Retinoic acid (RA) is gold standard treatment for photoaging. ISO for photoaging treatment was reported in non-controlled trials as alternative to RA, which causes skin irritation.ObjectiveTo compare clinical, histological, and immunohistochemical effects of low-dose ISO and 0.05% topical RA to treat photoaging.MethodsRandomized, comparative, evaluator-blinded, single-center study. Twenty-four healthy, Caucasian, 50 to 75-year-old men and women (menopausal or sterilized) with advanced photoaging were included. Twelve subjects received ISO, 20 mg/day, and 12 subjects were treated with RA cream, for six months; both treatments were administered every other day, and moisturizer and sunscreen were also used. Outcome measures included patient assessments, blinded photographic evaluations, Life Quality Index, histological (HE, Verhoeff) and immunohistochemical (p53, collagen type I) evaluations, adverse events, liver function, lipid profile, and blood count. Statistical analysis with generalized estimating equations and repeated measures ANOVA tests was used.ResultsEleven subjects in each group completed the study. Patient and photographic assessments showed overall improvement in skin appearance. Quality-of-life scores were reduced for all subjects. Histological analysis revealed corneal layer diminution, epidermal thickness increase, and elastosis reduction. Immunohistochemical findings revealed significant epidermal p53 reduction and dermal collagen 1 increase. No differences were found between groups; laboratory tests showed no significant alterations.ConclusionDespite being safe and effective, low-dose ISO was not superior to 0.05% RA for advanced photoaging treatment.
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 2009/51271-9
Date 2014-01-01
Published in International Journal of Dermatology. Hoboken: Wiley-Blackwell, v. 53, n. 1, p. 114-122, 2014.
ISSN 0011-9059 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 114-122
Origin http://dx.doi.org/10.1111/ijd.12191
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000328543600066
URI http://repositorio.unifesp.br/handle/11600/37123

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