Long-term oral isotretinoin therapy successfully treated patients with Morbihan disease, according to study results.
Five patients with Morbihan disease (MD; aged 21 to 61 years; three women) were treated with long-term oral isotretinoin for more than 6 months (mean, 16 months) at the Department of Dermatology, New York University Langone Medical Center. Sustained daily dose was a mean of 60 mg/d, and cumulative dose was a mean of 285 mg/kg.
Patients were treated from 10 to 24 months with a mean disease-free follow-up of 9 months. Within 4 to 6 weeks of treatment, improvements in facial erythema and edema were observed. At 6 months, substantial clinical improvement was noted in all patients. There was no documented disease recurrence.
Researchers noted that previous reports had documented the use of oral isotretinoin for treatment of MD at recommended doses ranging from 10 mg/d to 50 mg/d for 4 to 6 weeks, which was substantially lower than the effective dosage in the study. All patients were assigned a starting dose of 20 mg/d, which was increased until clinical response was observed. Effective treatment was related to body weight, with patients weighing more than 70 kg receiving 80 mg/d daily and patients weighing between 50 kg and 60 kg receiving 40 mg/d to 60 mg/d.
Adverse events, including dry lips, joint pain and hyperlipidemia, were mild and easily treated.
“Morbihan disease has long been considered a refractory condition with discouraging treatment options,” the researchers concluded. “The use of long-term oral isotretinoin … is a promising alternative. Patients should be closely monitored given the safety profile of oral isotretinoin. Further research is required to better understand the pathogenesis of MD and isotretinoin’s mechanism of action in this condition.”
Disclosure: Researcher David E. Cohen, MD, MPH, has served as a consultant to and has received honoraria from Galderma.