MASSIVE ISOTRETINOIN INTOXICATION

We report a case of acute intoxication due to a massive overdose of is otretinoin. A 29-year-old male patient ingested 900 mg of isotretinoin corresponding to 12.5 mg (kg/day) or 30 times the prescribed dosage a nd 1 day later the patient experienced mild headache. Forty-eight hour s later, cheilitis, diffuse cutaneous xerosis and desquamation of the forehead and of the external auditory meatus occurred; cutaneous xeros is and cheilitis resolved spontaneously. We determined the serum level of isotretinoin and of 4-oxo-isotretinoin, its natural metabolite in sera taken 4, 5, 6 and 11 days following ingestion. The side-effects w ere mild and represented only exacerbations of some common isotretinoi n side-effects. To date, three other cases of isotretinoin overdosage have been reported. There was a low toxicity of isotretinoin overdose.