The Therapeutic Role of Isotretinoin in the Management of Behçet's Disease: A Single-Blinded, Controlled Therapeutic Study
April 2013 | Volume 12 | Issue 4 | Original Article | 68 | Copyright © April 2013
Khalifa E. Sharquie MD PhD,a Raad M. A. Helmi BDS PhD,b Adil A. Noiami MD DDV FICMS,c Raafa K. Al-Hayani MD DDV,d and Mohand A. A. Kadhom BDS MSce
aScientific Council of Dermatology and Venereology, Iraqi Board for Medical Specializations, Baghdad, Iraq
bDepartment of Oral Medicine, College of Dentistry, Al-Mustansiriya University, Baghdad, Iraq
cDepartment of Dermatology and Venereology, College of Medicine, Baghdad University, Baghdad, Iraq
dDepartment of Dermatology and Venereology, Baghdad Teaching Hospital, Baghdad, Iraq
eDohuk Specialized Dental Center, General Directorate of Health, Dohuk, Kurdistan, Iraq
PATIENTS and METHODS: This single-blind, controlled therapeutic study was conducted in the Department of Dermatology and Venereology at Baghdad Teaching Hospital from February 2011 to January 2012. Thirty patients with BD were included in this work. Each patient received isotretinoin 20 mg orally once daily for 3 months. They were assessed at week 2 and then monthly depending on the Clinical Manifestation Index (CMI) and to record any side effects. At week 12, isotretinoin was stopped and patients were given placebo therapy in a form of glucose capsules for another 3 months.
RESULTS: Thirty patients were treated, 14 (46.6%) males and 16 (53.3%) females, with a male to female ratio of 1:1. Their ages ranged from 16 to 64 years (mean +/- standard deviation [SD], 38.4 +/- 10.9 years). During the first 3 months of therapy, the pathergy test, oral pathergy test, and C-reactive protein were significantly minimized. The CMI before isotretinoin therapy ranged between 2 and 8 (mean +/- SD, 4.933 +/- 1.91). After therapy, within the first 14 days, the mean CMI started to decline to a lower level, and it continued to decline significantly until week 12. It then started to increase through week 4 of placebo therapy, but remained statistically significant until the second month of placebo therapy. Isotretinoin therapy also had a statistically significant effect in reducing oral ulcers and skin manifestations.
CONCLUSION: Isotretinoin is an effective therapeutic and prophylactic drug in the management of BD.
J Drugs Dermatol. 2013;12(4):e68-e73.