REFERRAL PATTERNS AND ISOTRETINOIN TREATMENT OF PATIENTS WITH ACNE-VULGARIS IN A TEACHING HOSPITAL DERMATOLOGY DEPARTMENT OVER A 1-YEAR PERIOD

Patients with acne vulgaris, a common and debilitating disorder, may h ave tried a variety of prescribed and over-the-counter preparations pr ior to referral to hospital. Often treatment will have included expens ive antibiotics given for prolonged periods, the cost effectiveness of which is questionable. We studied prospectively the referral pattern of patients with acne vulgaris to a teaching hospital dermatology depa rtment over a 1-year period, the treatment in the community prior to r eferral, and the treatment pattern instigated by the hospital, We foun d that 88% of a total of 110 patients had been treated with systemic a ntibiotics for a period of up to 15 years prior to referral to a derma tologist, that 56% of general practitioners and 10% of patients had sp ecifically requested treatment of their acne vulgaris with isotretinoi n, that 82% of the referred patients were treated with their first cou rse of isotretinoin, and that 4.5% of the referred patients required a further course of isotretinoin, We conclude that there is very consid erable pressure on dermatologists to initiate treatment of acne vulgar is with isotretinoin from both general practitioners and the public, t hat treatment in the community is often expensive and inadequate, and that isotretinoin is an effective and relatively cost-effective treatm ent option for acne vulgaris.