Comparison of dapsone gel and nadifloxacin cream in the adjuvant treatment of acne vulgaris patients on systemic isotretinoin therapy: A retrospective study

Background and Design: We aimed to compare the additional impact of dapsone gel and nadifloxacin cream as adjuvant treatments with systemic isotretinoin for moderate and severe acne vulgaris.
Materials and Methods: We retrospectively compared patients with moderate-to-severe acne vulgaris who received dapsone 7.5% gel or nadifloxacin 1% cream in combination with oral isotretinoin treatment at Altunizade and Ataþehir Acýbadem Hospitals between January 2021 and October 2023. Isotretinoin treatment was administered at fixed low doses of 10-30 mg/day alongside topical treatments until the lesions resolved. Thereafter, oral isotretinoin was continued as monotherapy for an additional two months after the clearance of active lesions.
Results: A total of 74 patients, 34 in the dapsone group (24 female, 10 male) and 40 in the nadifloxacin group (21 female, 19 male), were included in the study. The time to complete clearance of active lesions and the total treatment time were significantly shorter in the dapsone group (2.68±0.18 and 5.15±0.14 months, respectively) than in the nadifloxacin group (3.43±0.15 and 5.8±1.9 months, respectively). The cumulative dose of isotretinoin was significantly lower in the dapsone group (3376.5±71.9 mg) than in the nadifloxacin group (4155±88.4 mg). Skin dryness was observed more frequently in the dapsone group (29.4% vs. 12.5%), but this difference was not statistically significant (p=0.071).
Conclusion: Topical dapsone gel may be an effective adjuvant therapy to accelerate the treatment response to oral isotretinoin and reduce the cumulative dose of isotretinoin. However, larger prospective studies are needed to determine the optimal adjuvant treatment options.

Keywords: acne, nadifloxacin, dapsone, isotretinoin

Sistemik izotretinoin tedavisi alan akne vulgaris hastalarýnda yardýmcý tedavi olarak dapson jel ve nadifloksasin kremin karþýlaþtýrýlmasý: Bir retrospektif çalýþma

Amaç: Dapson jel ve nadifloksasin kremin sistemik izotretinoin tedavisine adjuvan olarak orta ve þiddetli akne vulgariste etkisini karþýlaþtýrmaktýr.
Gereç ve Yöntem: Altunizade ve Ataþehir Acýbadem Hastanesi’nde Ocak 2021 ve Ekim 2023 tarihleri arasýnda oral izotretinoin tedavisine adjuvan olarak dapson %7,5 jel veya %1 nadifloksasin krem kullanan orta ve þiddetli akne vulgaris hastalarýnýn tedavi sonuçlarý retrospektif olarak karþýlaþtýrýldý. Aktif lezyonlarýn tam kontrolüne kadar günde 10-30 mg sabit düþük dozda, topikal tedavilerle kombine olarak verilen izotretinoin tedavisine, aktif lezyonlarýn tam gerilemesinin ardýndan iki ay süreyle monoterapi olarak devam edildi.
Bulgular: Çalýþmaya dapson grubunda 34 (24 kadýn, 10 erkek), nadifloksasin grubunda 40 olmak üzere (21 kadýn, 19 erkek) toplam 74 hasta dahil edildi. Aktif lezyonlarýn tam gerileme süresi ve toplam tedavi süresi dapson grubunda (sýrasýyla 2,68±0,18 ve 5,15±0,14 ay) nadifloksasin grubuna (sýrasýyla 3,43±0,15 ve 5,8±1,9 ay) göre anlamlý olarak daha kýsaydý. Kümülatif izotretinoin dozu da dapson grubunda (3376,5±71,9 mg) nadifloksasin grubuna göre (4155±88,4 mg) anlamlý düþük bulundu. Deri kuruluðu dapson grubunda daha sýk izlenmesine raðmen (%29,4 vs %12,5) fark anlamlýlýða ulaþmadý (p=0,071).
Sonuç: Topikal dapson jel, oral izotretinoin tedavi yanýtýný hýzlandýrmak ve kümülatif izotretinoin dozunu düþürmek için etkili bir adjuvan tedavi olabilir. Bununla birlikte, optimal adjuvan tedavi seçeneklerini belirlemek için daha geniþ prospektif çalýþmalara ihtiyaç vardýr.

Anahtar Kelimeler: akne, nadifloksasin, dapson, izotretinoin