A case of vitiligo developed after isotretinoin therapy

Abstract

Oral isotretinoin, a 13-cis retinoic acid and a derivative of the retinoids, is very effective for severe nodulocystic acne and papulopustular acne, which at times turns scar-forming and resistant. Common mucocutaneous and ocular dryness are the side effects. Also, musculoskeletal symptoms such as back pain, arthralgia, and myalgia may be seen in about 16% of adults post-isotretinoin therapy, usually resolving after treatment discontinuation. Depressive side effects and suicidal thoughts are concerns voiced against its use. Vitiligo is an autoimmune disorder characterized by the selective loss of melanocytes and depigmented patches on the skin. Recently, it has been classified to include metabolic, oxidative stress, genetic, and environmental factors. We present a very rare case of vitiligo developing after systemic isotretinoin therapy in a 24-year-old female patient with severe nodulocystic acne. The patient responded well to topical treatment, and her lesions improved significantly during the five months of follow-up. This case points out that, when prescribing isotretinoin, dermatologists should consider all possible dermatological adverse effects, including vitiligo, and conduct timely intervention and monitoring.