Isotretinoin Treatment Practices and Outcomes in Acne Patients During the COVID-19 Pandemic: A Single Center, Retrospective, Comparative Study
Keywords:
isotretinoin, treatment, acne, COVID-19, pandemicAbstract
Introduction: The COVID-19 pandemic drastically changed the priorities in healthcare services; outpatient management of acne has changed during this period.
Objectives: We aimed to investigate treatment practices, outcomes and identify modified follow-up schedules applied during the pandemic.
Methods: The patients who were admitted to dermatology outpatient clinic between March 13 and July 13, 2020, were included. Patients who were admitted between March 13 and July 13, 2019, were served as controls for the study. For each patient, age, gender, treatment protocols, treatment intervals, compliance with the treatment, treatment modifications, and adverse events were recorded.
Results: The total number of acne patients admitted to dermatology outpatient clinics during the pandemic period was 278 and consisted of 12.3% (278) of all admissions. Isotretinoin treatment was started in only 16 (5.8%) of the patients. The proportion of patients who were under follow-up was significantly higher during the pandemic period (P < 0.005). There was no difference between the pandemic period and the non-pandemic period in terms of starting isotretinoin treatment (P > 0.05). During pandemic period, 79% of the patients who used isotretinoin were followed-up every two or more months. Extended follow-up intervals showed no difference for detecting side effects (P > 0.05).
Conclusions: Acne patients constitute an important part of dermatology outpatient clinics. During the pandemic period, the majority of acne patients came for follow-up. Extended follow-up periods were adopted by physicians and were found safe and effective in the current study. Thus, isotretinoin treatment seems efficacious and safe during pandemic period.
References
Kutlu Ö, Güneş R, Coerdt K, Metin A, Khachemoune A. The effect of the "stay-at-home" policy on requests for dermatology outpatient clinic visits after the COVID-19 outbreak. Dermatol Ther. 2020;33(4):e13581. DOI: 10.1111/dth.13581. PMID: 32401401. PMCID: PMC7272831.
Sharma A, Jindal V, Singla P, Goldust M, Mhatre M. Will teledermatology be the silver lining during and after COVID-19? Dermatol Ther. 2020;33(4):e13643. DOI: 10.1111/dth.13643. PMID: 32441373. PMCID: PMC7267127.
Alshiyab DM, Al-Qarqaz FA, Muhaidat JM. Impact of COVID-19 pandemic on the continuity of care for dermatologic patients on systemic therapy during the period of strict lockdown. Ann Med Surg (Lond). 2020;60:571-4. DOI: 10.1016/j.amsu.2020.11.056. PMID: 33251007. PMCID: PMC7686756.
Aslan Kayiran M, Karadag AS, Jafferany M. Psychodermatology of acne: Dermatologist's guide to inner side of acne and management approach. Dermatol Ther. 2020;33(6):e14150. DOI: 10.1111/dth.14150. PMID: 32770727.
Pasion R, Paiva TO, Fernandes C, Barbosa F. The AGE Effect on Protective Behaviors During the COVID-19 Outbreak: Sociodemographic, Perceptions and Psychological Accounts. Front Psychol. 2020; 11:561785. DOI: 10.3389/fpsyg.2020.561785. PMID: 33178069. PMCID: PMC7595956.
Searle T, Ali FR, Al-Niaimi F. Identifying and addressing "Maskne" in clinical practice. Dermatol Ther. 2021;34(1):e14589. DOI: 10.1111/dth.14589. PMID: 33244836.
Han C, Shi J, Chen Y, Zhang Z. Increased flare of acne caused by long-time mask wearing during COVID-19 pandemic among general population. Dermatol Ther. 2020;33(4):e13704. DOI: 10.1111/dth.13704. PMID: 32472634. PMCID: PMC7300566.8. Damiani G, Gironi LC, Grada A, et al. COVID-19 related masks increase severity of both acne (Maskne) and rosacea (Mask rosacea): Multi-center, real-life, telemedical, observational prospective study. Dermatol Ther. 2021:e14848. DOI: 10.1111/dth.14848. PMID: 33533563. PMCID: PMC7995182.
Abdelmaksoud A, Vestita M, El-Amawy HS, et al. Isotretinoin therapy in the era of COVID-19. Dermatol Ther. 2020;33(4):e13482. DOI: 10.1111/dth.13482. PMID: 32358858. PMCID: PMC7261989.
British Association of Dermatologists . Guidance for Managing Patients on Isotretinoin During The Coronavirus Pandemic 2020. Available from: https://www.bad.org.uk/shared/get-file.ashx?itemtype=document&id=6661.
Pathoulas JT, Farah RS, Fiessinger L, Mansh M. An opportunity for improvement: iPLEDGE policy changes during the coronavirus pandemic. Dermatol Ther. 2020;33(6):e14411. DOI: 10.1111/dth.14411. PMID: 33052629. PMCID: PMC7646038.
Ruggiero A, Megna M, Annunziata MC, et al. Teledermatology for acne during COVID-19: high patients' satisfaction in spite of the emergency. J Eur Acad Dermatol Venereol. 2020;34(11):e662-e663. DOI: 10.1111/jdv.16746. PMID: 32534472. PMCID: PMC7323158.
Kim JK, Crimmins EM. How does age affect personal and social reactions to COVID-19: Results from the national Understanding America Study. PLoS One. 2020;15(11):e0241950. DOI: 10.1371/journal.pone.0241950. PMID: 33170903. PMCID: PMC7654776.
Dessinioti C, Zouboulis CC, Bettoli V, Rigopoulos D. Comparison of guidelines and consensus articles on the management of patients with acne with oral isotretinoin. J Eur Acad Dermatol Venereol. 2020;34(10):2229-2240. DOI: 10.1111/jdv.16430. PMID: 32277497.
Lee YH, Scharnitz TP, Muscat J, Chen A, Gupta-Elera G, Kirby JS. Laboratory Monitoring During Isotretinoin Therapy for Acne: A Systematic Review and Meta-analysis. JAMA Dermatol. 2016;152(1):35-44. DOI: 10.1001/jamadermatol.2015.3091. EPMID: 26630323.
Choi JS, Koren G, Nulman I. Pregnancy and isotretinoin therapy. CMAJ. 2013;185(5):411-413. DOI: 10.1503/cmaj.120729. PMID: 23296582. PMCID: PMC3602257.
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