Case Reports
6 December 2024
Early Access
Nightmares caused by isotretinoin in treating hidradenitis suppurativa: a case report and clinical insights
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
828
Views
195
Downloads
Authors
Isotretinoin, widely used for treating severe acne, has also been prescribed off-label for hidradenitis suppurativa (HS). While effective in some cases, isotretinoin is known to cause psychiatric side effects. This case report discusses a 24-year-old male with HS who developed severe nightmares after isotretinoin dosage was increased. Initially prescribed to manage his HS symptoms, the drug led to vivid, distressing nightmares that significantly disrupted his sleep, resulting in the discontinuation of treatment. The symptoms resolved upon cessation of isotretinoin, and a probable association was confirmed using the Naranjo algorithm. The patient was later transitioned to adalimumab, a biologic therapy for HS. This case highlights the need for careful psychiatric monitoring during isotretinoin therapy and emphasizes the importance of considering alternative treatments in cases of intolerable side effects. Further research is necessary to understand better the psychiatric implications of isotretinoin, including sleep disturbances like nightmares.
Altmetrics
Downloads
Download data is not yet available.
Citations
Patel N, McKenzie SA, Harview CL, et al. Isotretinoin in the treatment of hidradenitis suppurativa: a retrospective study. J Dermatolog Treat [Internet] 2021 [cited 2024 Sep 14];32:473–5. Available from: https://www.tandfonline.com/doi/abs/10.1080/09546634.2019.1670779 DOI: https://doi.org/10.1080/09546634.2019.1670779
Lewandowski M, Świerczewska Z, Barańska-Rybak W. Hidradenitis suppurativa: a review of current treatment options. Int J Dermatol [Internet] 2022 [cited 2024 Sep 14];61:1152–64. Available from: https://pubmed.ncbi.nlm.nih.gov/35128643/ DOI: https://doi.org/10.1111/ijd.16115
Huang CM, Kirchhof MG. A New Perspective on Isotretinoin Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review of Patient Outcomes. Dermatology [Internet] 2017 [cited 2024 Sep 14];233:120–5. Available from: https://pubmed.ncbi.nlm.nih.gov/28641306/
Bagatin E. Oral isotretinoin: the most promising dermatological off-label uses. Expert Rev Dermatol [Internet] 2010 [cited 2024 Sep 14];5:617–26. Available from: https://www.tandfonline.com/doi/abs/10.1586/edm.10.58 DOI: https://doi.org/10.1586/edm.10.58
Dessinioti C, Dréno B, Bettoli V, et al. Isotretinoin‐associated acne fulminans: A multicentre, retrospective study of the European Academy of Dermatology and Venereology Task Force on Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol [Internet] 2024 [cited 2024 Oct 21];38:197–204. Available from: https://doi.org/10.1111/jdv.19477 DOI: https://doi.org/10.1111/jdv.19477
Huang CM, Kirchhof MG. A New Perspective on Isotretinoin Treatment of Hidradenitis Suppurativa: A Retrospective Chart Review of Patient Outcomes. Dermatology [Internet] 2017 [cited 2024 Oct 21];233:120–5. Available from: https://doi.org/10.1159/000477207 DOI: https://doi.org/10.1159/000477207
Jørgensen AHR, Thomsen SF, Ring HC. Isotretinoin and hidradenitis suppurativa. Clin Exp Dermatol [Internet] 2019 [cited 2024 Oct 21];44:e155–6. Available from: https://doi.org/10.1111/ced.13944 DOI: https://doi.org/10.1111/ced.13953
Hambly R, Kirby B. Biologic survival in hidradenitis suppurativa: much done, more to do. Br J Dermatol [Internet] 2021 [cited 2024 Oct 21];185:16–7. Available from: https://doi.org/10.1111/bjd.20399 DOI: https://doi.org/10.1111/bjd.20399
Wysowski DK, Pitts M, Beitz J. An analysis of reports of depression and suicide in patients treated with isotretinoin. J Am Acad Dermatol [Internet] 2001 [cited 2024 Sep 14];45:515–9. Available from: https://pubmed.ncbi.nlm.nih.gov/11568740/ DOI: https://doi.org/10.1067/mjd.2001.117730
Suuberg A. Psychiatric and Developmental Effects of Isotretinoin (Retinoid) Treatment for Acne Vulgaris. Curr Ther Res Clin Exp [Internet] 2019 [cited 2024 Sep 14];90:27. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6383167/ DOI: https://doi.org/10.1016/j.curtheres.2019.01.008
Kontaxakis VP, Skourides D, Ferentinos P, et al. Isotretinoin and psychopathology: a review. Ann Gen Psychiatry [Internet] 2009 [cited 2024 Sep 14];8. Available from: https://pubmed.ncbi.nlm.nih.gov/19154613/ DOI: https://doi.org/10.1186/1744-859X-8-2
Lucca J, Varghese N, Ramesh M, Ram D. A case report of isotretinoin-induced manic psychosis. Indian J Dermatol 2016;61. DOI: https://doi.org/10.4103/0019-5154.174091
Bremner JD, Shearer KD, McCaffery PJ. Retinoic acid and affective disorders: the evidence for an association. J Clin Psychiatry [Internet] 2012 [cited 2024 Sep 14];73:37–50. Available from: https://pubmed.ncbi.nlm.nih.gov/21903028/ DOI: https://doi.org/10.4088/JCP.10r05993
Thompson DF, Pierce DR. Drug-induced nightmares. Ann Pharmacother [Internet] 1999 [cited 2024 Sep 14];33:93–8. Available from: https://pubmed.ncbi.nlm.nih.gov/9972389/ DOI: https://doi.org/10.1345/aph.18150
Gieselmann A, Ait Aoudia M, Carr M, et al. Aetiology and treatment of nightmare disorder: State of the art and future perspectives. J Sleep Res [Internet] 2019 [cited 2024 Sep 14];28:28. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6850667/ DOI: https://doi.org/10.1111/jsr.12820
Bremner JD. Isotretinoin and neuropsychiatric side effects: Continued vigilance is needed. J Affect Disord Rep 2021;6:100230. DOI: https://doi.org/10.1016/j.jadr.2021.100230
Steer RA, Cavalieri TA, Leonard DM, Beck AT. Use of the Beck depression inventory for primary care to screen for major depression disorders. Gen Hosp Psychiatry 1999;21:106–11. DOI: https://doi.org/10.1016/S0163-8343(98)00070-X
Kyriakou A, Trigoni A, Galanis N, et al. Efficacy of adalimumab in moderate to severe hidradenitis suppurativa: Real life data. Dermatol Reports [Internet] 2018 [cited 2024 Sep 14];10:26–30. Available from: https://pubmed.ncbi.nlm.nih.gov/30370041/ DOI: https://doi.org/10.4081/dr.2018.7859
How to Cite
Nightmares caused by isotretinoin in treating hidradenitis suppurativa: a case report and clinical insights. (2024). Dermatology Reports. https://doi.org/10.4081/dr.2024.10171
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
