RSS Feeds
Neurotoxicity and Tretinoin
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
We read with interest the case report linking neurotoxicity to the use of large amounts of topical tretinoin [1]. We wonder, however, whether some portion of the described clinical picture might be attributable to a confounding medication that has central nervous system activity, such as cyclobenzaprine. Although the most commonly reported adverse effects include dizziness, dry mouth, and drowsiness, ataxia and dysarthria have also been reported [2]. Obtaining plasma levels for other co-ingested medications may be a reasonable step in discovering the cause of the presenting problems of an unreliable patient who has access to unprescribed medication. Measurement of these levels can also yield surprising information after known ingestion of drugs whose plasma kinetics show large intersubject variability (such as cyclobenzaprine, with its half-life of ≥ 3 days) or in patients with possible metabolic deficiencies, such as hepatic disease.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
