Friday, 24 September 2010

Acne and Isotretinoin

Does Isotretinoin therapy cause depression? Maybe, maybe not - all depends on who you speak to.

The argument against Isotretinoin therapy causing depression is that its used for severe acne. Having severe acne could probably cause depression anyway. Well, thats what the latest psychiatrist to take a mild interest in the Fuddled Medics education said. According to wikipedia though, Isotretinoin has produced behaviour of dperession in rars though.

Another example of how you can argue anything you want in medicine if you think about it (althoug some things are set in stone).

The above point also illustrates how psychiatry is linked to the rest of medicine, depression arises due to a severe, disabling skin condition. Another one is that 10% of hospital patients will get delirium, something that can be quite hard (in practice, not in theory) to distinguish from dementia.

And with regards to dementia, is it due an underlying organic cause? Or are they quiete and unresponsive due a care home induced depression?

Dermatology is often seen as a bit of a joke subject by student, if you have a patient with a rash in front of you just flick though a book until you find the right picture. This can't really be done, textbooks show pictures of the "classical" disease, not the shades of grey in between.

What also isolates this speciality is that there is no dermatology wards, 99% of dermatologists deal with outpatients and dont do ward rounds.

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