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Isotretinoin is a systemic retinoid for severe nodulocystic acne. It lowers sebaceous gland activity and reduces inflammatory lesions. Oral, highly lipophilic with hepatic metabolism and lipid elevations. Requires strict pregnancy prevention (iPLEDGE) and monitoring of liver enzymes and lipids. Common adverse effects: mucocutaneous dryness; teratogenic risk; mood changes. Prescription required.
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