Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Effect of Isotretinoin Treatment on the Inflammatory Markers in Patients with Acne Vulgaris: A Case-Control Study
İzotretinoin Tedavisinin Akne Vulgarisli Hastalarda İnflamatuar Belirteçler Üzerine Etkisi: Bir Olgu Kontrol Çalışması
Mahir DIĞIŞa , Mustafa TOSUNa , Rukiye YASAK GÜNERa , Melih AKYOLa
aDepartment of Dermatology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Türkiye
Turkiye Klinikleri J Dermatol. 2024;34(1):1-7
doi: 10.5336/dermato.2023-97752
Article Language: EN
Full Text
ABSTRACT
 Objective: Oral isotretinoin can affect inflammation markers in patients with acne vulgaris. This study aims to examine the impact of isotretinoin treatment on inflammatory markers in patients diagnosed with acne vulgaris. Material and Methods: Fifty-five patients diagnosed with moderate or severe acne vulgaris according to the Global Acne Grading Scale were included in this study. Patients were evaluated at regular intervals (at 0, 2nd, and 3rd months) during the treatment period. Complete blood count [including mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), plateletcrit, platelet distribution width (PDW), platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW)], Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), monocyte-high-density lipoprotein (HDL) ratio, monocyte-to-lymphocyte ratio (MLR), MPV/platelet ratio, and serum biochemistry panel were assessed during isotretinoin treatment. Additionally, the Acne Quality of Life Scale was used to assess patients' quality of life. Results: A significant increase in PLR and RDW levels was observed during isotretinoin treatment (p<0.05). However, SII, SIRI, AISI, monocyte/HDL ratio, NLR, PDW, MPV, sedimentation rate, and C-reactive protein levels did not show a significant change during isotretinoin treatment (p>0.05). Furthermore, this study demonstrated that oral isotretinoin treatment reduced the severity of acne and improved patients' quality of life. Conclusion: Isotretinoin may have inflammatory effects shown with PLR and RDW. However, other inflammatory markers did not show a significant change during isotretinoin treatment. Further comprehensive studies are needed to better understand the relationship between isotretinoin treatment and inflammatory markers.

Keywords: Isotretinoin; inflammatory markers; acne vulgaris
ÖZET
 Amaç: Oral izotretinoin, akne vulgarisli hastalarda inflamasyon belirteçlerini etkileyebilir. Bu çalışma, izotretinoin tedavisinin akne vulgarisli hastaların inflamatuar belirteçleri üzerindeki etkilerini incelemeyi amaçlamaktadır. Gereç ve Yöntemler: Bu çalışmaya, Global Akne Derecelendirme Ölçeği'ne göre orta veya şiddetli akne vulgarisi tanısı alan 55 hasta dâhil edildi. Hastalar, tedavi başlangıcında ve tedavi süresince düzenli aralıklarla (0, 2 ve 3. aylarda) değerlendirildi. Tam kan sayımı [ortalama trombosit hacmi (mean platelet volume ''MPV''), nötrofil-lenfosit oranı (neutrophil-to-lymphocyte ratio ''NLR''), plateletkrit, trombosit dağılım genişliği (platelet distribution width ''PDW''), trombosit-lenfosit oranı (platelet-to-lymphocyte ratio ''PLR''), kırmızı hücre dağılım genişliği (red cell distribution width ''RDW'')], Sistemik İmmün-İnflamasyon İndeksi (Sİİ), Sistemik İnflamasyon Yanıt İndeksi [Systemic Inflammation Response Index (SIRI)], Toplu Sistemik İnflamasyon İndeksi [Aggregate Index of Systemic Inflammation (AISI)], monosit-yüksek yoğunluklu lipoprotein [high-density lipoprotein (HDL)] oranı, monosit-lenfosit oranı [monocyte-to-lymphocyte ratio (MLR)], MPV/trombosit oranı ve serum biyokimya paneli, izotretinoin tedavisi süresince değerlendirildi. Ayrıca, hastaların yaşam kalitesini değerlendirmek için Akne Yaşam Kalitesi Ölçeği kullanıldı. Bulgular: İzotretinoin tedavisi sırasında PLR ve RDW seviyelerinde anlamlı bir artış tespit edildi (p<0,05). Ancak, Sİİ, SIRI, AISI, monosit/HDL oranı, NLR, PDW, MPV, sedimantasyon hızı ve C-reaktif protein düzeyleri izotretinoin tedavisi sırasında anlamlı bir değişiklik göstermedi (p>0,05). Ayrıca, bu çalışma, oral izotretinoin tedavisinin akne şiddetini azalttığını ve hastaların yaşam kalitesini iyileştirdiğini göstermiştir. Sonuç: İzotretinoin, PLR ve RDW ile gösterilebilen inflamatuar etkilere sahip olabilir. Ancak, izotretinoin tedavisi sırasında diğer inflamatuar belirteçlerde belirgin bir değişiklik gözlenmemiştir. İzotretinoin tedavisi ile inflamasyon belirteçleri arasındaki ilişkiyi daha iyi anlamak için daha fazla kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: İzotretinoin; inflamatuar belirteçler; akne vulgaris
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