Treatment of Acanthosis Nigricans With Oral Isotretinoin

There is now considerable evidence that the synthetic retinoid agent, isotretinoin (13-cis-retinoic acid), is effective in the management of many disorders of keratinization previously thought to be resistant to treatment by other agents.1Lamellar ichthyosis, Darier's disease, and pityriasis rubra pilaris appear to be particularly responsive, with other disorders of keratinization showing a variable response.2Only recently, it has been shown that the retinoid agent is effective in severe cystic acne vulgaris, giving prolonged remissions in some cases.3The patient with extensive acanthosis nigricans described in this article was successfully treated with oral isotretinoin using the protocol of a multicenter clinical trial of the drug to test its effectiveness in disorders of keratinization. Selection of this disease for treatment with the oral retinoid agent was based on success using topical tretinoin in some patients with acanthosis nigricans.4 Report of a Case A 33-year-old woman