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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".