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Article
January 1993

Isotretinoin Does Prevent Skin Cancer

Author Affiliations

National Cancer Institute Bethesda, MD 20892; Department of Dermatology University of Maryland School of Medicine Baltimore, MD 21201

Arch Dermatol. 1993;129(1):43. doi:10.1001/archderm.1993.01680220055011
Abstract

To the Editor.—  The editorial "Isotretinoin Does Not Prevent Basal Cell Carcinoma" that appeared in the July 1992 issue of the Archives is wrong. As with any effective therapy, dosage considerations are essential. Higher doses of isotretinoin are effective in preventing skin cancer, while low doses (10 mg/d) are not. Furthermore, the writers' major contention that a "controlled clinical trial" of isotretinoin has not demonstrated utility for prevention of human skin cancers is not correct.A 3-year controlled prospective study with isotretinoin examined five patients with xeroderma pigmentosum who had multiple basal cell or squamous cell carcinomas.2 The patients had a total of 121 tumors in the 2-year interval before treatment. During the 2 years of treatment with oral isotretinoin (2 mg/kg per day) there were 25 tumors with an average reduction in new skin cancers of 63% (P=.02). However, all patients experienced substantial toxic reactions. After isotretinoin

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