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    Isotretinoin’s discovery and development

    Expert discusses pearls gleaned from initial clinical observations

    Audio fileListen to the discussionDermatology Times editorial advisor Dr. Elaine Siegfried talks with Jim Leyden, M.D., emeritus professor of dermatology at the University of Pennsylvania about the art and science of isotretinoin therapy. Dr. Leyden, aside from being a member of the famed Acne Mafia, was a really active participant in the drug development process for isotretinoin, a drug for which, the institutional memory about that process may be fading. The two discuss many of the important initial clinical observations and those that others have made over the years.

    READ: Isotretinoin dosing decisions

    Acne Mafia Development and clinical use 

    Dr. Elaine SiegfriedDr. Siegfried: I want to thank you for participating and I really appreciate the chance to pick your brain about the art and the science of isotretinoin therapy. I was going to launch into talking a little bit about the Acne Mafia and their greatest legacy, which was in the development and clinical use of isotretinoin for severe acne. Before I ask you about some insider history on the development of isotretinoin, can you give me some insider information on why you, Alan and John were called the Acne Mafia?

     Isotretinoin audio recordings

    Dr. Leyden: My recollection was that the three of us were sitting and talking just before a session at the Academy. A group came in and somebody declared us the Acne Mafia. Somehow that stuck, and I said,  “Well, OK John, you can be the Don and Alan can be your consigliere, what am I?” He said, “You’re a foot soldier.”

    READ: How to recognize sinus tracts, keratinous cysts

    Dr. Siegfried: Perhaps because John Strauss was my mentor and chairman of my department, but the Acne Mafia taught me a huge amount about treating acne and the safe and effective use of isotretinoin. Even more than that, the Acne Mafia was responsible for having incredible educational sessions.

    NEXT: Early days of isotretinoin

    Elaine Siegfried, M.D.
    Elaine Siegfried, M.D., is professor of pediatrics and dermatology, Saint Louis University Health Sciences Center, St. Louis, Mo. She ...


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