{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:52:03Z","timestamp":1791352323899,"version":"4.3.1"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,8,22]],"date-time":"2012-08-22T00:00:00Z","timestamp":1345593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background\u2002<\/jats:bold>\n                    Isotretinoin, for acne treatment, is associated with high rates of permanent remission. However, at recommended doses of 0.5\u20101.0 mg\/kg\/day for 5\u20106 months [average cumulative dose: 120\u2010150 mg\/kg], more than 20% of patients experience a relapse within two years that requires further medical management.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objective\u2002<\/jats:bold>\n                    To examine outcomes of high\u2010dose isotretinoin in a cohort with cystic acne, as well as measuring its impact on quality of life (QOL).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods\u2002<\/jats:bold>\n                    A single dermatologist, single institution investigation within an academic tertiary care center in Bronx, NY. Eighty patients with nodulocystic acne, maintained on oral isotretinoin at a dose of 1.3 mg\/kg\/day or greater, were studied from 2006\u20102009 while additionally participating in a QOL survey. Main outcome measures included documented events, acne clearance, presence of relapse, and quality of life parameters.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results\u2002<\/jats:bold>\n                    The mean daily dose of isotretinoin was 1.6 mg\/kg\/day for an average time course of 178 days [cumulative dose: 290 mg\/kg]. No side effects or laboratory abnormalities led to discontinuation of treatment. There were no psychiatric symptoms. One\u2010hundred percent (100%) of patients were disease\u2010free upon completion of treatment. During the three\u2010year study period, 10 patients (12.5%) developed a relapse that required an additional course of isotretinoin. Analysis of QOL domains (\n                    <jats:italic>self\u2010perception, role\u2010social, symptoms<\/jats:italic>\n                    ) revealed significant improvement following isotretinoin therapy (p = 0.0124, p = 0.0066, p = 0.0265, respectively).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions\u2002<\/jats:bold>\n                    Isotretinoin prescribed at 1.5 mg\/kg\/day or greater for 5\u20106 months [cumulative total dose of 290 mg\/kg] is safe and effective compared to current standard dosing practices. We propose the use of high\u2010dose isotretinoin (&gt;1.3 mg\/kg\/day) as a treatment option in severe nodulocystic acne and encourage larger, prospective, multicenter studies into this therapeutic approach.\n                  <\/jats:p>","DOI":"10.1111\/j.1365-4632.2011.05409.x","type":"journal-article","created":{"date-parts":[[2012,8,22]],"date-time":"2012-08-22T02:47:53Z","timestamp":1345603673000},"page":"1123-1130","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["High\u2010dose isotretinoin in acne vulgaris: improved treatment outcomes and quality of life"],"prefix":"10.1111","volume":"51","author":[{"given":"Amanda A.","family":"Cyrulnik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate V.","family":"Viola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron J.","family":"Gewirtzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,8,22]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2009.00635.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2009.03806.x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1159\/000151441"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0009922808315444"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-007-0777-2"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2006.02660.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp033487"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.5-6-569"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.02.012"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.6.726"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-0960.2002.00612.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sder.2008.07.002"},{"key":"e_1_2_6_14_2","unstructured":"Roche Laboratories.Accutane Insert Document. 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