Isotretinoin's Symptom Survey Tool
From depression to suicide, the controversy surrounding the use of isotretinoin in teenage patients is well known. While there is not much you can do to put out the fire surrounding isotretinoin, you may be able to quell parental fears by being thorough. Dr. Lawrence Eichenfield introduced the Symptom Survey Tool at today's meeting at the annual Hawaii Dermatology Seminar sponsored by Skin Disease Education Foundation.
Dr. Eichenfield created the Symptom Survey Tool and uses it in his office to monitor his isotretinoin patients. He said the benefits of the survey tool include improved clinical assessment, efficiency, and billing and documentation. The survey asks patients whether or not they experience a list of adverse events. Some of the items included on the survey are dry lips, nose bleeds, headache, dry skin, depression, mood swings, and suicidal thoughts.
In a recent study that Dr. Eichenfield conducted of 102 patients (J. Am. Acad. Dermatol, in press), he found that the vast majority of self-reported "depression" was not "true clinical expression." Psychological issues require a proactive approach, and the need to determine "what's real" and "what's imagined." He advised the audience to liberally refer and comanage depression patients with a psychiatrist or psychologist. He noted that he doesn't usually discontinue isotretinoin therapy in patients that report mood swings unless they are significant.
The most common side effects in his isotretinoin study were dry lips and dry skin. He found a very low level of mood swings and depression. The drug was very well tolerated, he said.
A video interview with Dr. Eichenfield about his survey tool will be posted soon. And news from the Hawaii dermatology seminar is being posted throughout the week.
Amy
Managing Editor