Psychiatric disorders such as depression, irritability, psychosis, attempted suicide, and actual suicide have been reported in individuals during and after isotretinoin therapy. However, there is no evidence that the use of isotretinoin is associated with an increased risk for depression or suicide. Psychiatric evaluation and treatment may still be needed (Brecher and Orlow 2003, Ellis and Krach 2001).
In conclusion, dapsone and retinoids may be useful alternatives in the treatment of resistant skin lesions and in patients with CLE refractory to other therapeutic regimens, given as monotherapy or in combination with antimalarials or cortico-steroids, considering the indication and the possible side effects.