Bilateral nasal bone osteophytosis associated with short-term oral isotretinoin therapy for cystic acne vulgaris

      This paper is only available as a PDF. To read, Please Download here.


      Bilateral 2.5 and 3.0 mm nasal bone osteophytes developed five weeks following the initiation of oral isotretinoin therapy (50 mg daily) for severe cystic acne vulgaris in a healthy 30-year-old white woman who had undergone uneventful rhinoplasty 12 years earlier. Histologically mature bone fragments were removed at surgery. Vitamin A and its analogs have been reported to cause hyperostosis of the vertebrae and long bones, but no known reports link them to nasal bone changes. Clinically significant nasal bone osteophytosis may be another adverse reaction to oral isotretinoin therapy.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Peck GL
        • Olsen TG
        • Yoder FW
        • et al.
        Prolonged remissions of cystic and conglobate acne with 13-cis-retinoic acid.
        N Engl J Med. 1979; 300: 329-333
        • Farrell LN
        • Strauss JS
        • Stranieri AM
        The treatment of severe cystic acne with 13-cis-retinoic acid. Evaluation of sebum production and the clinical response in multiple-dose trial.
        J Am Acad Dermatol. 1980; 3: 602-611
        • Jones M
        • Blanc D
        • Cunliffe WJ
        13-cis-retinoic acid and acne.
        Lancet. 1980; II: 1048-1049
        • Pochi PE
        Oral retinoids in dermatology (special report).
        Arch Dermatol. 1982; 118: 57-61
        • Peck GL
        • Yoder FW
        Treatment of lamellar icthyosis and other keratinizing dermatoses with an oral synthetic retinoid.
        Lancet. 1976; II: 1172-1174
        • Peck GL
        • Yoder FW
        • Olsen TG
        • et al.
        Treatment of Darier's disease, lamellar icthyosis, pityriasis rubra pilaris, cystic acne and basal cell cancer with oral 13-cis-retinoic acid.
        Dermatologica. 1978; 157: 11-12
        • Elias PM
        • Williams ML
        Retinoids, cancer and the skin.
        Arch Dermatol. 1981; 117: 160-180
        • Meyskens Jr, FL
        • Gilmartin E
        • Alberts DS
        • et al.
        Activity of isotretinoin against squamous cell cancers and preneo-plastic lesions.
        Cancer Treat Rep. 1982; 66: 1351
        • Peck GL
        • Gross EG
        • Butkus D
        • DiGiovanni JJ
        Chemoprevention of basal cell carcinoma with isotretinoin.
        J Am Acad Dermatol. 1982; 6: 815
        • Windhorst DB
        • Nigra T
        General clinical toxicology of oral retinoids.
        J Am Acad Dermatol. 1982; 6: 675-682
        • Gerber A
        • Raab AP
        • Sobel AE
        Vitamin A poisoning in adults: with description of a case.
        Am J Med. 1954; 16: 729-745
        • Pittsley RA
        • Yoder FW
        Retinoid hyperostosis: skeletal toxicity associated with long-term administration of 13-cis-retinoic acid for refractory icthyosis.
        N Engl J Med. 1983; 308: 1012-1014
        • Oliver TK
        Chronic vitamin A intoxication: report of a case in an older child and review of the literature.
        Am J Dis Child. 1958; 95: 57-68
        • Hoffman-LaRoche, Inc.
        Accutane (isotretinoin) in the treatment of severe, recalcitrant cystic acne.
        Roche Scientific Summary. 1982; : 32
        • Cho DY
        • Frey RA
        • Guffy MM
        • Liepold HW
        Hypervitaminosis A in the dog.
        Am J Vet Res. 1975; 36: 1597-1603
        • Seawright AA
        • English PB
        • Gartner RJ
        Hypervitaminosis A and hyperostosis of the cat.
        Nature. 1965; 206: 1171-1172
        • Rees TD
        Aesthetic plastic surgery. vol 1. WB Saunders, Philadelphia1980: 337