Abstract
In this study, we aimed to describe isotretinoin-induced nail changes and to increase patients' compliance with treatment. A total of 200 patients diagnosed with acne vulgaris were included in the study, including 100 patients who started systemic isotretinoin treatment and 100 control patients who received topical acne treatment. The patients age, gender, treatment duration, total doses per month, type of nail changes were recorded. Patients with persistent nail changes were followed at 3rd and 6th month after treatment. A total of 34 patients had nail changes in the isotretinoin group. These changes included onychoschizia (55.9%), leukonychia (11.8%), onychorexis (8.8%), median nail dystrophy (5.9%), pyogenic granulomas (5.9%), chronic paronychia and granulation tissue (5.9%), onycholysis (2.9%) and Beau's line (2.9%). The rate of nail changes in the isotretinoin group was significantly higher than the topical treatment group (34% vs 11%, p:0.001). There was no statistically significant difference in terms of treatment duration between the patients with and without nail changes in the isotretinoin group. The total cumulative dose was significantly higher in patients with nail changes in isotretinoin group (p:0.043). Also, the regression of nail changes was slower in patients receiving higher cumulative doses (p:0.049). Isotretinoin increases the risk of nail changes, the most common being onychoschizia. The risk of developing nail changes have no association with treatment duration; however, it is associated with the total cumulative dose. Nail findings inducedby isotretinoin are completely reversible.