Seborrheic dermatitis-like eruption in patients taking isotretinoin therapy for acne: Retrospective study of five patients

Aviv Barzila*, Michael David, Henri Trau, Emmilia Hodak

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Isotretinoin therapy for acne is often associated with mucocutaneous reactions that are usually dose dependent. Objective: To describe the characteristics of five patients who presented with a peculiar facial rash that developed during or after a successful course of isotretinoin therapy for acne. Methods: In this retrospective study, five patients who were treated with isotretinoin and who developed, during or following treatment, a peculiar facial eruption that has not previously been reported, are described. The clinical characteristics, laboratory findings, therapy, and course of the eruption are presented. Results: The rash was characterized by small, yellow, adherent, greasy scales, either flat-topped or spiky, mostly on the cheeks, that resembled seborrheic dermatitis. Cultures obtained in one case grew Staphylococcus coagulase-negative, Acinetobacter, and Pityrosporum ovale organisms. In another patient, microscopic study showed hyperkeratotic scales with many spores and Gram-negative coccobacilli. Topical administration of ointments containing chloramphenicol 3% for 2-3 weeks was curative. Conclusion: Seborrheic dermatitis-like eruption may be another adverse cutaneous effect of isotretinoin treatment. Its pathogenesis probably involves a minimal toxic retinoid effect on epidermal differentiation with overgrowth of commensal microorganisms in susceptible individuals.

Original languageEnglish
Pages (from-to)255-261
Number of pages7
JournalAmerican Journal of Clinical Dermatology
Issue number4
StatePublished - 2008


  • Acne, treatment
  • Isotretinoin, adverse reactions
  • Seborrhoeic dermatitis


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