Effect of 6-Month Isotretinoin Treatment on 25-Hydroxyvitamin D Levels in Patients With Acne Vulgaris

Влияние 6-месячной терапии изотретиноином на уровни 25-гидроксивитамина D у пациентов с юношеской угри
Gülbahar Saraç 1, Tuba Tülay Koca 2, Serpil Şener 1, Gülden Hakverdi 3
More Detail
1 Department of Dermatology İnonu University, Malatya, Turkey
2 Department of Physical Medicine and Rehabilitation, Sütçü İmam University, Kahramanmaraş, Turkey
3 Department of Biostatistics, Cumhuriyet University, Sivas, Turkey
J CLIN MED KAZ, Volume 1, Issue 47, pp. 25-28. https://doi.org/10.23950/1812-2892-JCMK-00537
OPEN ACCESS 5041 Views 2180 Downloads
Download Full Text (PDF)

ABSTRACT

Objectives: Acne is a chronic inflammatory disease that affects the pilosebaceous units of the skin. Isotretinoin is a derivative of the synthetic 13-cis-retinoic acid and is an efficient drug for acne treatment. In clinical studies, the negative effects of long-term and short-term isotretinoin use on vitamin D levels and bone metabolism restrict its use. In this study, the effect of isotretinoin treatment on vitamin D levels was examined in patients with acne vulgaris.
Material and Methods: Ninety patients with clinically diagnosed acne vulgaris who came to the Malatya Research and Training Hospital Dermatology Clinic participated in this study. Patients who had been using any systemic drug for the previous month or who had any systemic disease were not included in the study. Patients with abnormalities in calcium (Ca), alkaline phosphatase (ALP), and parathyroid hormone (PTH) levels, which affect vitamin D metabolism, also were not included in the study. Patients were treated first with 0.5 to 1.0 mg/kg (per kilogram of body weight) doses of isotretinoin, with the aim of total dosage of 120 mg/kg. The patients’ 25-hydroxy vitamin D3 [25'(OH) vit D3] levels were measured before treatment and at the sixth month of treatment.
Results: Among the 90 patients who participated in the study, 51 (56.7%) were female, and 39 (43.3%) were male, with an age range of 16 to 50 years (mean ±standard deviation) age, 23.55±5.58 years. Eight patients dropped out of the study. The patients’ (mean ± standard deviation) 25'(OH) vit D3 level was 18.28±9.92 before treatment and 13.28±7.78 at the sixth month of treatment (p=0.000).
Conclusion: The negative effect of isotretinoin on vitamin D levels and bone metabolism has been shown in previous studies. In this study, 25'(OH) vit D3 levels decreased significantly in patients treated with isotretinoin in the long term (p>0.000).

CITATION

Saraç G, Koca TT, Şener S, Hakverdi G. Effect of 6-Month Isotretinoin Treatment on 25-Hydroxyvitamin D Levels in Patients With Acne Vulgaris. Journal of Clinical Medicine of Kazakhstan. 2018;1(47):25-8. https://doi.org/10.23950/1812-2892-JCMK-00537

REFERENCES

  • Saraç G, Koca TT, Şener S, Cenk H. A Comparison of Vitamin D Levels in Patients with Acne Vulgaris and Healthy Individuals. J Clin Med Kaz. 2017; 2(44):33-35.
  • Blasiak RC, Stamey CR, Burkhart CN, Lugo-Somolinos A, Morrell DS. High-dose isotretinoin treatment and the rate of retrial, relapse, and adverse effects in patients with acne vulgaris. JAMA Dermatology. 2013; 149(12):1392-8.
  • Bhambri S, Del Rosso JQ, Bhambri A. Pathogenesis of acne vulgaris: recent advances. J Drugs Dermatol. 2009; 8(7):615-8.
  • Tekin NS, Ozdolap S, Sarikaya S Keskin SI. Bone mineral density and bone turnover markers in patients receiving a single course of isotretinoin for nodulocystic acne. Int J Dermatol. 2008; 47(6):622-5.
  • Khatri KA, Garcia V: Light-assisted hair removal in patients undergoing isotretinoin therapy. Dermatol Surg. 2006; 32:875-7.
  • Mahrle G, Bauermeister-Jasso K, Enderer K. Roaccutane in acne and rosacea. Z Hautkr. 1985; 60(1-2); 120; 125-34.
  • Kindmark A, Rollman O, Mallmin H, Petren-Mallmin, Ljunghall S. Oral isotretinoin therapy in severe acne induces transient suppression of biochemical markers of bone turnover and calcium homeostasis. Acta DermVenereol. 1998; 78(4):266-9.
  • Goodman G: Managing acne vulgaris effectively. AustFamPhysician. 2006; 35:705-9.
  • Sinclair W, Jordaan HF: Acne guideline 2005 update. S AfrMed J. 2005; 95:881-92.
  • Özmen İ, Köse O. Vitamin D and Skin. Turkish Journal of Dermatology. 2008; 2:77-83.
  • Rodland O, Aksnes L, Nilsen A, Morken T. Serum levels of vitamin D metabolites in isotretinoin treated acne patients. Acta Derm Venereol. 1992; 72(3):217-9. 
  • Ertuğrul DT, Karadağ AS, Tutal E, Akın KO. Does isotretinoin have effect on vitamin D physiology and bone metabolism in acne patients? Dermatologic Therapy. 2011; 24:291-95.
  • Halverstam CP, Zeichner J, Lebwohl M. Lack of significant skeletal changes after long-term, low-dose retinoid therapy: case report and review of the literature. J Cutan Med Surg. 2006; 10(6):291-9.
  • Trifiro G, Norbiato G. Type I collagen N-telopeptide variation in adolescents receiving oral isotretinoin for severe acne. J Pediatr EndocrinolMetab. 2002; 15(1):35-9.
  • Vestergaard P, Rejnmark L, Mosekilde L. High-dose treatment with vitamin A analogues and risk of fractures. Arch Dermatol. 2010; 146(5):478-82. doi: 10.1001/archdermatol.2010.59.