Efficacy of oral isotretinoin monotherapy compared to combination isotretinoin and topical clascoterone for severe acne vulgaris: a multi-center retrospective study
Bibliographic record
Abstract
Introduction Severe nodular acne causes significant psychological distress and reduces quality of life. Clascoterone 1% cream, a novel anti-androgen with a favorable safety profile, may enhance the efficacy of oral isotretinoin, the gold-standard therapy for severe acne. This study compared isotretinoin monotherapy with isotretinoin plus topical clascoterone 1% cream.Methods Since June 2023, patients with severe/nodular acne at university-affiliated dermatology clinics were treated with isotretinoin, alone or combined with clascoterone 1% cream twice daily. In December 2024, records were retrospectively reviewed. The analysis included patients aged ≥12 years with severe/nodular acne who received isotretinoin (0.5–0.8 mg/kg/day) with or without clascoterone 1% cream for ≥24 weeks. Outcomes included facial lesion count, Investigator’s Global Assessment (IGA), and facial xerosis at week 24.Results Eighty-two patients (44 monotherapy; 38 combination therapy) were included. Both groups showed significant reduction in facial lesion count (p < 0.001), but between-group differences were not significant. More patients in the combination group achieved IGA 0/1 (92.1% vs. 72.7%; p < 0.05). Xerosis rates were lower in the combination group (84% vs. 91%) but not statistically significant.Conclusion Clascoterone 1% cream may enhance isotretinoin efficacy without worsening adverse effects, offering a promising approach for severe/nodular acne. Further studies are needed to confirm long-term benefits.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".