A cerebellar demyelinating lesion following treatment of acne with isotretinoin

Clin Exp Dermatol. 2008 Mar;33(2):118-21. doi: 10.1111/j.1365-2230.2007.02429.x. Epub 2007 May 14.

Abstract

We report the case of a demyelinating lesion located in the left cerebellar region that developed 3 months after the onset of oral isotretinoin treatment. In April 2001, 1 year before admission, the patient underwent cranial magnetic resonance imaging (MRI) because of endocrinological problems. This was found to be completely normal. In January 2002, oral isotretinoin treatment was started to treat severe acne. Three months after the onset of therapy, the patient reported lack of appetite, faintness and tinnitus. Her second cranial MRI scan showed a cerebellar lesion, and oral isotretinoin treatment was stopped (April 2002). One month after the cessation of oral isotretinoin treatment, the lesion became less prominent on the MRI scan, and after 3 months, it had disappeared. Although it is difficult to determine the causal association between the demyelinating cerebellar lesion and isotretinoin treatment, we would like to alert physicians to this possibility, because of the common usage of this drug in daily practice.

Publication types

  • Case Reports

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Adult
  • Cerebellum / diagnostic imaging
  • Demyelinating Diseases / chemically induced*
  • Demyelinating Diseases / diagnostic imaging
  • Dermatologic Agents / administration & dosage
  • Dermatologic Agents / adverse effects*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Humans
  • Isotretinoin / administration & dosage
  • Isotretinoin / adverse effects*
  • Radiography
  • Treatment Outcome
  • Vitamin A / administration & dosage
  • Vitamin A / adverse effects*
  • Withholding Treatment

Substances

  • Dermatologic Agents
  • Vitamin A
  • Isotretinoin