YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==ACCUTANE SIDE-EFFECTS== 1 AUTHOR Westerman ST AUTHOR Gilbert LM AUTHOR Schondel L TITLE Vestibular dysfunction in a child with embryonic exposure to accutane. SOURCE Am J Otol 1994 May;15(3):400-3 ABSTRACT Children with a history of embryonic exposure to Accutane (isotretinoin) are at great risk for major physical malformations, brain malformations, and decreased intelligence. A case is presented of a 4-year 7-month-old black male with a history of embryonic exposure to Accutane who was born with embryopathy that includes bilateral major ear deformities. The child has a significant bilateral conductive hearing loss, and, in addition, a left sided sensorineural loss. Vestibular function testing revealed evidence of peripheral and central vestibular dysfunction. A course of diphenhydramine hydrochloride and Donnatal (phenobarbital, hyoscyamine sulfate, atropine sulfate, and scopolamine hydrobromide) significantly alleviated the symptoms of vestibular dysfunction. Otologic management of these children should include clinical documentation of the external deformities, evaluation of cochlear function, and early auditory habilitation. Vestibular function should also be evaluated in all children with a history of embryonic exposure to isotretinoin. 5 AUTHOR Lerman S TITLE Ocular side effects of accutane therapy. SOURCE Lens Eye Toxic Res; VOL 9, ISS 3-4, 1992, P429-38 ABSTRACT The recent interest in treating acne with one of the retinoid drugs has been accompanied by a wide variety of ocular side effects involving the eyelids, cornea, lens, optic nerve and retina. In one group of patients being evaluated for possible efficacy of a retinoic acid analogue in treating psoriasis, several patients complained of difficulty driving at night due to decreased dark adaptation which we were able to document. Fortunately, most of the above side effects tend to disappear within months after the drug is discontinued. However, we have recently seen two cases of dry eye syndrome associated with Accutane therapy that have persisted for more than two years. In addition, scattered reports have appeared regarding cataracts in young patients (teens to early 40's) which developed during, and/or after Accutane treatment. We have examined lens matter derived from two such patients who had extracapsular cataract extractions. Their lens proteins showed an elevation in UV absorptivity (between 330-390 nm) compared with matched control material (derived from Eye Bank specimens) and HPLC analyses demonstrated an abnormal peak in their profiles which was similar to one present in control samples incubated with retinoic acid and was not present in lens protein samples derived from cataracts not associated with Accutance therapy. These observations demonstrate that some of the Accutane induced ocular side affects are not reversible when the drug is stopped, and patients on such therapy should be carefully monitored. 11 AUTHOR Lane PR AUTHOR Hogan DJ TITLE Granulomatous lesions appearing during isotretinoin therapy SOURCE Can. Med. Assoc. J.; VOL 130 ISS Mar 1 1984, P550, (REF 3) ABSTRACT IPA COPYRIGHT: ASHP Granulomatous lesions which appeared as a side effect of isotretinoin (Accutane; I; 13-cis-retinoic acid) therapy are reported in a 17-yr-old man who was being treated with 0.5 mg/kg to 2.0 mg/kg I per day for acne. The lesions caused no symptoms and disappeared in a month after I therapy was stopped.