Mechanism of Action [1

Contents

Contents

17.1

128

17.2

128

17.2.1

Mechanism of Action [1,2]

128

17.2.2

Clinical Experience

129

17.2.2.1

Isotretinoin Monotherapy for HS

129

17.2.3

Isotretinoin Therapy in Patients

with Acne and Coexistent HS

129

17.2.4

Isotretinoin in the Pre-

and Postoperative Phase

131

17.2.5

Isotretinoin in Combination Treatment

of HS

131

17.2.6

131

17.3

Etretinate and Acitretin

132

17.3.1

Mechanism of Action

132

17.3.2

Clinical Experience: Etretinate

and Acitretin for HS

132

17.3.3

134

References

134

The mechanism of action of isotretinoin in HS is unknown. In HS, the initial event is believed to be poral occlusion. Retinoids can normalize follicular cornification, although etretinate and acitretin have a clearly greater effect than isotretinoin in disorders of keratinization [3]. It has also been shown that isotretinoin can reduce ductal hypercornification [4]. Isotretinoin possesses anti-inflammatory effects, reduces the chemotaxis of polymorphonuclear leucocytes and has been reported to enhance immune function [5, 6]. These properties may be of benefit in the treatment of HS. The main effect of isotretinoin is to decrease of the size and secretions of the sebaceous glands.

However, in contrast to what happens in acne, the size of sebaceous glands is not increased in HS. Isotretinoin also reduces the ductal population of Propionibacterium acnes, and although this has a very important effect on acne pathogenesis, it does not appear to be useful for the treatment of HS, because Propionibacterium acnes has not been cultured in HS lesions. Isotretinoin does not affect the size of apocrine glands.

Acne Myths Uncovered

Acne Myths Uncovered

What is acne? Certainly, most of us know what it is, simply because we have had to experience it at one time or another in our lives. But, in case a definition is needed, here is a short one.

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