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October 1983

Inflammatory Neovascular Nodules Associated With Oral Isotretinoin Treatment of Severe Acne

Author Affiliations

From the Department of Dermatology, University of California at Irvine.

Arch Dermatol. 1983;119(10):871-872. doi:10.1001/archderm.1983.01650340081024

Isotretinoin is extremely effective in the treatment of severe cystic acne.1,2 We have recently noted the occurrence of inflammatory neovascular nodules

See also p 808. (INNs), or exuberant nodular granulation tissue, in two of 12 patients with severe acne who were treated with oral isotretinoin.

Report of Cases 

Case 1.—  A 17-year-old boy with severe acne was entered into the Hoffmann-La Roche Isotretinoin Study. His acne had progressed while he was receiving conventional topical, intralesional, and oral therapy all of which were discontinued several weeks prior to entry into the study. Physical examination of the patient revealed numerous, crusted, draining, inflammatory nodulocystic lesions associated with sinus tracts, pustules, comedones, and mild scarring involving the face, neck, upper aspect of the trunk, and proximal, upper part of the arms. According to the study protocol, the patient began receiving a moderately low dose (1 mg/kg/day) of oral isotretinoin, which was increased