Nearly all teens will get acne at one time or another. For those that get severe acne, it can be devastating to their self-esteem. While acne isn’t a serious health problem, it’s not something that is easy to hide.
For a lot of teens, over-the–counter face washes and drying agents help keep acne under control. For more serious acne, families often turn to a dermatologist for prescription medicine.
In certain people, Aczone- the skin gel version of the drug Dapzone -may lead to a rare blood disorder called methemoglobinemia according to a new study.
That’s what a 19 year-old female in Pittsburgh was using to treat her acne before she entered the emergency room with a headache, shortness of breath, and blue lips and fingers. At first, her doctors were at a loss as to what was causing her condition.
The patient had been using a “pea-size” amount of Aczone on her face twice daily during the previous week and didn’t think to tell the doctors about it when questioned about any medications she was taking.
"We went over all her meds and herbal supplements," said Dr. Greg Swartzentruber, a medical toxicology fellow at the University of Pittsburgh Medical Center. "And we couldn't come up with a cause, even after interviewing her and her family. Aczone was just never mentioned."
Topical medicines can have systemic adverse effects on people, but many patients don’t think about topical creams or gels when asked about medications they are on by their doctor.
The study authors noted that prior research has shown that Dapsone pills, in very rare instances, can trigger methemoglobinemia, the abnormal production of a red blood cell protein that delivers oxygen throughout the body.
But the current case appears to be the first time that this condition has been associated with Aczone, the skin gel version of Dapsone, they said.
Dapzone pills have been available for decades and were once used to treat leprosy. In 2005, the FDA approved Aczone - the 5 percent topical cream – for acne treatment use. Dapzone and Aczone have been very effective for treating acne.
However, if someone has the rare genetic defect that makes it impossible to properly metabolize the drugs, it can cause serious health problems.
"The blood cells blow up, basically," said Dr. Darrell Rigel, a clinical professor of dermatology with New York University Medical Center in New York City. Rigel added. "The prevalence of this deficiency is very low. Maybe it affects less than 1 percent of the population, but those that have it can end up with serious problems."
Doctors were finally able to diagnose the young woman’s illness through a urine test. She was successfully treated and released from the hospital after two days.
Rigel noted that dermatologists who prescribe Aczone have a responsibility to always screen patients for this issue. "And patients have to know that when they're asked to give their drug history they can't forget their topicals," he said.
The young woman’s case was described in a letter published in the New England Journal of Medicine.
Source: Alan Mozes, http://www.webmd.com/skin-problems-and-treatments/acne/news/20150129/acne-gel-linked-to-rare-side-effect-doctors-warn