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

Abstract

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 Ata & scedil;ehir Ac & imath;badem 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.