Blistering eruptions following isotretinoin therapy for hidradenitis suppurativa: a case report

Ehiaghe L. Anaba, Ruth I. Oaku


A 33-year-old male was treated with isotretinoin (20mg daily) for hidradenitis suppurativa. After 6 weeks on the medication, he developed symmetrical erythematous tense blisters on the lower legs. Report of biopsy done was of intraepidermal blisters with superficial dermal lymphohistiocytic infitrates. He was commenced on oral prednisolone 30mg daily and Isotretinoin was withdrawn. The blisters resolved over a 2week period. The lesions of hidradenitis suppurativa were noticed to have improved with the short course of isotretionoin.



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Dupuy E, Alexanian S, Hsiao J. Galli-Galli Disease Responsive to Isotretinoin Treatment. Int J Dermatol. 2018;57:1123-4.

Sehgal VN, Srivastava G, Sardana K. Isotretinoin- unapproved indications/uses and dosage: a physician’s reference. Int. J. Dermatol. 2006;45:772-7.

Patil S, Apurwa A, Nadkarni N, Agarwal S, Chaudhari P, Gautam M. Hidradenitis Suppurativa: Inside and Out. Indian J Dermatol. 2018;63:91-8.

Jansen T, Plewig G. Acne Inversa. Int J Dermatol. 1998;37:96-100.

Calao M, Wilson JL, Spelman L, Billot L, Rubel D, Watts AD, Jemec GBE. Hidradenitis suppurativa (HS) prevalence, demographics and management pathways in Australia: a population-based cross-sectional study. PLoS ONE. 2018;13:e0200683.

Davis SA, Lin HC, Balkrishnan R, Feldman SR. Hidradenitis suppurativa management in the united states: an analysis of the national ambulatory medical care survey and marketscan medicaid databases. Skin Appendage Dis. 2015;1:65-73.

Vaidya T, Vangipuram R, Alikhan A. Examining the race-specific prevalence of hidradenitis suppurativa at a large academic center; results from a retrospective chart review. Dermatol Online J. 2017;15:23.

Vlassova N, Kuhn D, Okoye GA. Hidradenitis suppurativa disproportionately affects African Americans: a single-center retrospective analysis. Acta Derm Venereol. 2015;95:990-1.

Lee DE, Clark AK, Shi VY. Hidradenitis suppurativa: disease burden and etiology in skin of color. Dermatology. 2017;233(6):456-61.

Scheinfeld N. Hidradenitis suppurativa: a practical review of possible medical treatments based on over 350 hidradenitis patients. Dermatol Online J. 2013;19:1.

Nickle SB, Peterson N, Peterson M. Updated physician’s guide to the off-label uses of oral isotretinoin. J Clin Aesthet Dermatol. 2014;7:22-34.

Boer J. Are there indications for isotretinoin treatment of hidradenitis suppurativa? Dermatol. 2017;233:111-2.

Huang CM, Kirchhof MG. A new perspective on isotretinoin treatment of hidradenitis suppurativa: a retrospective chart review of patient outcomes. Dermatol. 2017;233:120-5.

Brzezinski P, Borowska K, Chiriac A, Smigielski J. Adverse effects of isotretinoin: a large, retrospective review. Dermatol. Ther. 2017;30:4e12483.

Yazici AC, Baz K, Ikizoglu G. Recurrent herpes labialis during isotretinoin therapy: is there a role for photosensitivity? JEADV. 2006;20:93-5.

Saray Y, Seçkin D. Angioedema and urticaria due to isotretinoin therapy. JEADV. 2006;20:118-20.

Turel A, Ozturkcan S, Sahin MT, Turkdogan P. A rare side-effect of systemic isotretinoin treatment: pyogenic granuloma. JEADV. 2003;17:609-10.

Tinoco MP, Tamler C, Maciel G, Soares D, Avelleira JC, Azulay D. Pyoderma gangrenosum following isotretinoin therapy for acne nodulocystic. Int J Dermatol. 2008;47:953-6.

Elpern DJ, Burns JA. Atypical Pyoderma as a Side Effect of Isotretinoin. J Am Acad. Dermatol. 1985;6:1045-6.

Filho RR, Almeida HL, Lorencette NA, Netto JF. Acute generalized exanthematous pustulosis induced by isotretinoin. Int J Dermatol. 2010;49:1077-8.

Bigby M, Stern RS. Adverse reactions to isotretinoin. a report from the adverse drug reaction reporting system. J Am Acad Dermatol. 1988;18:543-52.

Caballero RC, Nagore E, Sanmartín O, Botella‐Estrada R, Serra C, Guillen C. Vesiculous prurigo pigmentosa in a 13‐year‐old girl: good response to isotretinoin. JEADV. 2005;19:474-6.