Can oral isotretinoin be safely initiated and monitored in primary care? A case series

Oral isotretinoin has traditionally been prescribed only in secondary care for severe or resistant acne. To explore whether this drug can be safely initiated and monitored in primary care by a GP with extra training in dermatology. One hundred consecutive patients who were started on oral isotretinoin therapy in a primary care centre were retrospectively reviewed. One hundred percent of the patients with acne who completed their course of isotretinoin were cleared at the end of treatment. Twenty-three of the eighty-one patients (28%) who were followed-up after a mean of 5 years relapsed and eighteen (22%) had to have at least one more course of isotretinoin. Seventy-four of seventy-seven (96%) patients who had long-term follow-up were satisfied with the level of care they received in primary care. This study suggests that oral isotretinoin can be safely initiated and monitored by a GP with a special interest in dermatology and experience in prescribing systemic retinoids.