[Isotretinoin and adolescent depression].

BACKGROUND: Isotretinoin, indicated in France in the treatment of severe acne (e.g. nodular acne, acne conglobata or acne likely to result in permanent scarring) resistant to adequate cure by standard systemic antibiotic therapy and topical treatments, has on occasion been suspected of being associated with suicide. A study involving collective reflection on this issue is presented herein.

METHODS: The Psychodermatology Group of the French Dermatology Society, made up of dermatologists, psychiatrists, paediatric psychiatrists, psychoanalysts and clinical psychologists, met several times and views were exchanged by e-mail. The first two authors drafted the present article, which was then re-read, modified and approved by the members of the Psychodermatology Group, in particular by the co-authors. The article was then modified at the request of the proofreaders of the Annales de Dermatologie and re-read once more by members of the Psychodermatology Group.

RESULTS: Psychological disturbances, including depression and other suicidal tendencies, are extremely common during adolescence and are clearly increased by acne, particularly where it is severe. Isotretinoin does not appear to increase this risk.

CONCLUSION: Routine screening should be performed for psychological disturbance in adolescents, particularly among those presenting acne. Prescription of isotretinoin is not contraindicated in subjects presenting depression.