Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Acne Vulgaris at Al-Thawrah General Hospital, Sanaa, Yemen

Abstract

Background: Acne vulgaris is one of the most common skin problems in adult life, especially in adolescents.
Objective: This study aimed to evaluate the efficacy of oral isotretinoin in combination with desloratadine in the treatment of acne vulgaris at Al-Thawra General Hospital, Sanaa.
Methods: The study was designed as a prospective comparative clinical trial carried out in the Department of Dermatology, Al-Thawrah General Hospital, Sanaa during the period from Jan. to June 2019. The data were collected from each patient after verbal consent. All patients (60 pt.) were randomized into 2 equal groups (study group and control group). The mean age of the study group was 27.47 ± 4.249 year while 24.07 ± 3.393 year of the control group. Both groups were treated with isotretinoin 20mg per day for 16 weeks. The study group (combined treatment) received 5mg desloratadine daily in 16 weeks. The follow-up was carried in weeks (2, 4, 8, 12, 16) for acne lesion, GAGS score, side effects of drugs and outbreak of acne.
Results: This study found that females were more affected than males and acne lesion at 16 weeks was 16.7 % in the study group in contrast to 40.0 % in the control group. After 16 weeks of treatment, GAGS score showed that both groups had good outputs response to therapy with 86.7% excellent and 13.3% good in the study group compared to 56.7%, excellent, and 40 % good response to therapy. Whereas at 16 weeks most patients had no outbreak (86.7 % in the study group and 53.3 % in the control group), 3% in the study group and 46.7 % in the control group had mild outbreak with > 5 nodules. This study observed only minor side effects of desloratadine among the study group, such as headache and self-limited infection. Side effects of isotretinoin declined more rapidly when desloratadine was added. In contrast, this study showed that 10 % of patients had chelitis, conjunctivitis and 13.3 % of them had priorities at 16 weeks.
Conclusion: This study showed that adding oral desloratadine to the oral isotretinoin provides a better outcome and advantage in terms of efficacy and tolerability than isotretinoin treatment alone.