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Guy Webster:
| • | for patient with truncal acne, will start Accutane with PO prednisone (20-40mg/day X first month) to avoid flare with keloids |
| • | rarely re-treats after less than 4 months |
| • | unknown how many times one can retreat (he has treated as often as 6 times) |
| • | 2-4 weeks repeat triglycerides, monitor until they plateau |
| • | 4-6 weeks repeat liver profile (again at end of treatment, or after 4 months) |
| • | contact lenses (extra lubricant, try not to wear overnight) |
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adverse effects:
| • | acute – increased triglycerides, LFT’s, dryness, hair loss, pseudotumor cerebri |
| • | chronic (>2 years) – demineralization of bones, premature closure of the epiphyses (short stature), calcification of tendons and ligaments |
total dose goal = 120 to 150 mg/kg (typically takes 6 months to achieve this total dose)
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