A randomized and controlled trial about the use of oral isotretinoin for photoaging

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dc.contributor.authorBagatin, Ediléia
dc.contributor.authorParada, Meire O.B.
dc.contributor.authorMiot, Hélio Amante [UNESP]
dc.contributor.authorHassun, Karime M.
dc.contributor.authorMichalany, Nilceo
dc.contributor.authorTalarico, Sergio
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-27T11:24:38Z
dc.date.available2014-05-27T11:24:38Z
dc.date.issued2010-02-01
dc.description.abstractTopical retinoids are used to treat photoaging; oral isotretinoin is gold standard for acne; off label indications, including photoaging, have been reported with insufficient evidence of efficacy. This is a randomized controlled phase II trial with clinical and histological assessment to evaluate efficacy and safety of oral isotretinoin for photoaging. Study population was comprised of 32 menopausal or sterilized women, aged 40-55, divided in 2 groups: A (21) received 20mg isotretinoin, 3 times per week, nightly moisturizer, and daily sunscreen, for three months; B (11) just moisturizer/sunscreen. Main outcome measures were: overall clinical assessment; profilometry, corneometer and elasticity tests in periocular regions and left forearm; before/after biopsies from left forearm in patients of B and in 10 randomly selected of A. Microscopic blinded evaluation of epidermal thickness, dermal elastosis, new collagen, p53 epidermal expression was performed by quantitative digital image analysis. All data were submitted to statistical analysis. Clinical evaluation showed slight improvement; profilometry, corneometer and skin elasticity tests presented significant difference in pre/post values (P = 0.001 to 0.028), but no differences between A/B. Histological findings and p53 expression were comparable between groups before treatment (P > 0.1); microscopic analysis showed no differences between groups for most variables, after treatment. Slight but significant difference between A/B for p53 with major reduction post isotretinoin [0.66±0.31 vs. 0.94±0.34 respectively (P = 0.04) was observed. There were minor side effects and no significant laboratory test alterations. We concluded that no significant clinical, microscopic changes but p53 epidermal expression reduction were observed. The role of ultra-violet induced p53 mutation in skin carcinogenesis reinforces retinoids chemoprevention. Oral isotretinoin seemed safe but not effective to treat photoaging. Caution should be considered for women prone to pregnancy. Further controlled studies are necessary. © 2010 The International Society of Dermatology.en
dc.description.affiliationDepartment of Dermatology UNIFESP - Univesidade Federal de Sao Paulo, Sao Pailo, SP
dc.description.affiliationDepartment of Pathology UNIFESP
dc.description.affiliationDepartment of Dermatology UNESP - Universidade do Estado de Sao Paulo Campus Botucatu, SP
dc.description.affiliationUnespDepartment of Dermatology UNESP - Universidade do Estado de Sao Paulo Campus Botucatu, SP
dc.format.extent207-214
dc.identifierhttp://dx.doi.org/10.1111/j.1365-4632.2009.04310.x
dc.identifier.citationInternational Journal of Dermatology, v. 49, n. 2, p. 207-214, 2010.
dc.identifier.doi10.1111/j.1365-4632.2009.04310.x
dc.identifier.issn0011-9059
dc.identifier.issn1365-4632
dc.identifier.lattes2543633050941005
dc.identifier.scopus2-s2.0-74949134508
dc.identifier.urihttp://hdl.handle.net/11449/71572
dc.language.isoeng
dc.relation.ispartofInternational Journal of Dermatology
dc.relation.ispartofjcr1.541
dc.relation.ispartofsjr0,610
dc.relation.ispartofsjr0,610
dc.rights.accessRightsAcesso restrito
dc.sourceScopus
dc.subjectcollagen
dc.subjectisotretinoin
dc.subjectprotein p53
dc.subjectsunscreen
dc.subjectadult
dc.subjectcheilitis
dc.subjectclinical article
dc.subjectclinical assessment
dc.subjectclinical trial
dc.subjectcontrolled clinical trial
dc.subjectcontrolled study
dc.subjectdepression
dc.subjectdrug efficacy
dc.subjectdrug safety
dc.subjectdrug use
dc.subjectdry nose
dc.subjectelasticity
dc.subjectepidermis
dc.subjectfemale
dc.subjectfemale sterility
dc.subjecthistology
dc.subjecthuman
dc.subjecthuman tissue
dc.subjectimage analysis
dc.subjectirritant dermatitis
dc.subjectmenopause
dc.subjectphase 2 clinical trial
dc.subjectphotoaging
dc.subjectprotein expression
dc.subjectrandomized controlled trial
dc.subjectside effect
dc.subjectskin biopsy
dc.subjectskin test
dc.subjectskinfold thickness
dc.subjectxerophthalmia
dc.subjectxerostomia
dc.subjectAdministration, Oral
dc.subjectAdult
dc.subjectAnalysis of Variance
dc.subjectDermatologic Agents
dc.subjectDose-Response Relationship, Drug
dc.subjectDouble-Blind Method
dc.subjectEsthetics
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectIsotretinoin
dc.subjectMiddle Aged
dc.subjectPatient Satisfaction
dc.subjectProbability
dc.subjectRisk Assessment
dc.subjectSkin Aging
dc.subjectStatistics, Nonparametric
dc.subjectTreatment Outcome
dc.titleA randomized and controlled trial about the use of oral isotretinoin for photoagingen
dc.typeArtigo
dcterms.licensehttp://olabout.wiley.com/WileyCDA/Section/id-406071.html
unesp.author.lattes2543633050941005
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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