Influence of isotretinoin on nasal mucociliary clearance and lung function in patients with acne vulgaris.

Retinoids are widely used to treat acne in patients with underlying systemic diseases. We evaluated the effect of 13-cis-retinoic acid (isotretinoin) on nasal mucociliary clearance and pulmonary function tests (PFTs) in patients with severe acne vulgaris. Each side effect was scored using a 4-point scale. Mucociliary clearance was evaluated by the saccharin test (ST). ST and PFTs were performed on all patients before and during the third month of treatment. A total of 40 acne patients (88% female, mean age 25 +/- 7 years) were included. The most common side effects were dryness, chapped lips, and xerosis. Mild epistaxis occurred in 13 patients; only two patients reported bleeding more than 10cc. There was no difference before and during the third month of treatment in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, forced expiratory flow rate between 25% and 75% of FVC (FEF(25-75)), and their predicted percentage ratios. Mean nasal mucociliary clearance time was 12.6 +/- 4.1 min before and 15.9 +/- 5.7 after treatment (P < 0.001). We found that nasal clearance was significantly prolonged with treatment, and there was significant correlation between drug dose and mucociliary clearance time. Isotretinoin caused signs and symptoms of dry nose and disturbed mucociliary clearance without affecting PFTs. Nasal complications generally are not serious, especially when isotretinoin is taken in low doses.