{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T04:28:46Z","timestamp":1792297726047,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Isotretinoin is the most effective treatment for severe acne, but optimal cumulative dosing remains debated. While 120\u2009mg\/kg is standard, some advocate higher doses or prolonged treatment to reduce relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare acne outcomes between 120 and 150\u2009mg\/kg cumulative isotretinoin dosing and to evaluate 12\u2010month relapse and scarring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010centre, randomized single\u2010blind trial, with blinded outcomes assessment, patients with moderate\u2010to\u2010severe cystic acne were allocated to cumulative isotretinoin doses of 120 or 150\u2009mg\/kg. Primary outcomes were changes in total lesion count and acne severity grade (1\u20138 scale) from baseline to mid\u2010treatment and end of treatment; secondary outcomes included 12\u2010month acne relapse and scarring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both cumulative dose groups showed comparable improvements in acne severity and lesion counts from baseline to treatment completion, with no significant differences between groups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.20). Scarring did not worsen over the course of treatment. At 12\u2009months after treatment discontinuation, relapse rates were similar between groups: 26.7% in the 120\u2009mg\/kg group and 32.3% in the 150\u2009mg\/kg group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.619). Adverse events were mild and comparable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Single\u2010centre design and retrospective trial registration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increasing dosing to 150\u2009mg\/kg provides no benefit. Extended therapy does not reduce relapse, supporting 120\u2009mg\/kg as optimal. Persistent acne required longer treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.70524","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:41:09Z","timestamp":1780314069000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cumulative isotretinoin dosing, treatment response and acne relapse: A randomized controlled trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1438-9553","authenticated-orcid":false,"given":"Ruggero","family":"Cascio Ingurgio","sequence":"first","affiliation":[{"name":"Dermatology Unit IRCCS Humanitas Research Hospital  Rozzano MI Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Alfano","sequence":"additional","affiliation":[{"name":"Dermatology Unit IRCCS Humanitas Research Hospital  Rozzano MI Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Dermatology Unit IRCCS Humanitas Research Hospital  Rozzano MI Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie S.","family":"Cronk","sequence":"additional","affiliation":[{"name":"Dermatology Consultants  Woodbury Minnesota USA"},{"name":"Minneapolis VA Medical Center  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Cummins","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Children's Hospital Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin S.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Dermatology St Vincent's Hospital Melbourne  Fitzroy Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben J.","family":"Koszegi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Dermatology St George Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda K.","family":"Martin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Melanoma Institute Australia The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarisse G.","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Immunodermatology Unit Research Institute for Tropical Medicine  Muntinlupa Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mae","family":"Ramirez\u2010Quizon","sequence":"additional","affiliation":[{"name":"Department of Dermatology Rizal Medical Center  Manila Philippines"},{"name":"Department of Dermatology Philippine General Hospital  Manila Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley M.","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Department of Dermatology St George Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather I.","family":"Rishel","sequence":"additional","affiliation":[{"name":"Rishel Enterprises, LLC  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam I.","family":"Rubin","sequence":"additional","affiliation":[{"name":"The Ronald O. 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