Two Colleagues, Two Perspectives: Report From the Society for Pediatric Dermatology Annual Meeting, Part 2

Lawrence F. Eichenfield, MD


October 10, 2002

In This Article

Oral Retinoids in Children

Seth J. Orlow, MD, PhD,[9] New York University School of Medicine, New York, NY, discussed the use of oral retinoids in pediatric patients. Isotretinoin (Accutane) and acitretin (Soriatane) are 2 commonly used retinoids for dermatologic conditions, although isotretinoin is approved by the US Food and Drug Administration (FDA) only for individuals age 12 years and older, and acitretin does not have any specific age indications.

Dr. Orlow discussed concerns about premature epiphyseal closure with courses of Accutane. Premature epiphyseal closure was reported by Milstone[10] with high doses (3.5 mg/kg/day) over multiple years. Dr. Orlow related that this has not been reported with the use of Accutane for acne vulgaris at standard doses and with standard duration of therapy. A recent study sponsored by Roche (unpublished data) showed no change in mean bone mineral density (BMD) with isotretinoin therapy, although a small percentage of patients had elevated or decreased BMD compared with BMD measures at the beginning of the study. However, Dr. Orlow stressed that no definite conclusions can be reached, because no normative reference BMDs for growing adolescents were available for comparison.


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