الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Acne is a chronic inflammatory disease of the pilosebaceous follicular unit mostly affecting adolescent age groups. It is present in skin regions with higher density of sebaceous glands, including face, chest and upper back.
The pathogenesis of acne vulgaris is multifactorial. It includes androgen and sebum overproduction, abnormal follicular keratinization, Propionibacterium acnes (P. acnes) proliferation, inflammation, immune response, external factors, and genetics.
Clinical presentation varies according to the severity of the disease. The primary acne lesions can be either inflammatory and/or non-inflammatory lesions. Non inflammatory lesions include open comedones (black heads) and closed comedones while for inflammatory lesions may be presented as papules, pustules, and nodules with a variable degree of erythema and tenderness.
Retinoid therapy has been a cornerstone for acne treatment as it acts on all four pathogenic factors of acne, ie sebaceous gland differentiation and sebum productions, C. acne colonization, inflammation and follicular keratinization.
Acne treatment poses a great management challenge as it needs a prolonged treatment course for a successful disease remission, this may associate with adverse effects which might affect compliance and adherence of patients to the treatment modality, consequently higher rate of relapse or treatment failure.
Cumulative dose of isotretinoin 120-150mg/kg is recommended by European guidelines as a standard dose for successful acne remission, however some of published literature have also recommended use of low dose or intermittent isotretinoin to overcome the adversity of high dose. Additionally, maintenance therapy has been recommended after stopping isotretinoin in order to prolong the period of acne remission. Medications studied for maintenance therapy were topical retinoids adapalene 0.1% alone or in combination with benzoyl peroxide 2.5% and antibiotics.
The aim of the current study was to assess the efficacy and tolerability of local adapalene gel as compared to systemic isotretinoin given on a weekend for the maintenance of acne remission induced by systemic isotretinoin.
To achieve this aim, data was collected from the records of 60 patients subdivide into 3 groups of 20 patients each based on their treatment regimens received. The first group I received full dose of isotretinoin with a cumulative dose 120-150mg followed by topical adapalene as a maintenance therapy, the second group II received full dose of isotretinoin with a cumulative dose 120-150mg followed by weekend oral isotretinoin as a maintenance therapy and the third group III received daily dose isotretinoin 0.3-0.5mg/kg followed by weekend oral isotretinoin as a maintenance therapy.
Comparison between three studied groups were made regarding frequency of recurrence after maintenance therapy, severity score based on IGA at recurrence, remission time and frequency of side effects of treatment phase and maintenance phase