Isotretinoin treatment alters steroid metabolism in women with acne

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Abstract
The effect of isotretinoin (Roaccutane) on serum steroids and urinary steroid metabolites was investigated in seven female patients receiving the drug for treatment of severe acne over a 16‐week period. Serum concentrations of dehydroepiandrosterone sulphate (DHAS), androstenedione (A2), and free androgen index (FAI) were not significantly altered. There was a significant fall in testosterone during treatment and a significant reduction in the 24 h urinary excretion of androsterone, tetrahydrocortisone (THE) and tetrahydrocortisol (THF) from week 8 onwards and for aetiocholanolone and allo‐THF from week 12 (P < 0.05). Although pretreatment levels of urinary steroid metabolites were not abnormal, the ratios of the 5α/5β metabolites (androsterone:aetiocholanolone and allo‐THF:THF) were at the upper limit of the reference range and were lowered after treatment, suggesting that 5α‐reductase activity is sensitive to isotretinoin.

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