Efficacy of Oral Low-Dose Isotretinoin in the Treatment of Acne Vulgaris in Vietnam
DOI:
https://doi.org/10.3889/oamjms.2019.094Keywords:
Acne vulgaris, Plasma homocysteine level, Serum folic acid level, Low dose isotretinoinAbstract
BACKGROUND: Oral isotretinoin is an effective therapy for acne. However, isotretinoin can induce hyperhomocysteinemia and decreased serum folic acid level, which may be a risk for cardiovascular disease and thrombosis, as well as psychoses. Besides, many recent types of research emphasise the safety and effects of the low dose isotretinoin therapy.
AIM: The aim of our study was to evaluate the effect of the low-dose isotretinoin on the plasma homocysteine and serum folic acid level in the Vietnamese population.
METHODS: We conducted a longitudinal study to evaluate the effectiveness of the low-dose therapy on the plasma homocysteine and serum folic acid level of 52 acne patients after 6-8-week treatment at University Medical Center Ho Chi Minh City, Viet Nam. Patients had moderate-severe acne with the prolonged course, and most of them had a scar.
RESULTS: With a low dose of oral isotretinoin (0.37 ± 0.11 mg/kg/day), after 6-8-week treatment, patients dropped the severity of disease, increased the plasma homocysteine level and decreased the serum folic acid level with significant differences in comparison to those before treatment. However, these changes do not exceed the normal range.
CONCLUSION: In overall, low dose isotretinoin treatment had effectiveness in decrease the severity of disease and no increasing the plasma homocysteine level as well as the serum folic acid level.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Zaenglein AL, Graber EM, Thiboutot DM. (2012). Acne vulgaris and acneiform eruption. Fitzpatrick's Dermatology in general medicine: Mc Graw Hill, 2012:897-917.
Bhate K, Williams HC. Epidemiology of acne vulgaris. British Journal of Dermatology. 2013; 168(3):474-85. https://doi.org/10.1111/bjd.12149 PMid:23210645 DOI: https://doi.org/10.1111/bjd.12149
Griffiths C, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook's textbook of dermatology. John Wiley & Sons, 2016. https://doi.org/10.1002/9781118441213 DOI: https://doi.org/10.1002/9781118441213
Tan JK, Bhate K. A global perspective on the epidemiology of acne. British Journal of Dermatology. 2015; 172:3-12. https://doi.org/10.1111/bjd.13462 PMid:25597339 DOI: https://doi.org/10.1111/bjd.13462
Charakida A, Mouser PE, Chu AC. Safety and side effects of the acne drug, oral isotretinoin. Expert opinion on drug safety. 2004; 3(2):119-29. https://doi.org/10.1517/14740338.3.2.119 PMid:15006718 DOI: https://doi.org/10.1517/14740338.3.2.119
Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. Jama. 2002; 288(16):2015-22. https://doi.org/10.1001/jama.288.16.2015 DOI: https://doi.org/10.1001/jama.288.16.2015
Den Heijer M, Rosendaal FR, Blom HJ, Gerrits WB, Bos GM. Hyperhomocysteinemia and venous thrombosis: a meta-analysis. Thrombosis and Haemostasis-Stuttgart-. 1998; 80(6):874-7. https://doi.org/10.1055/s-0037-1615380 DOI: https://doi.org/10.1055/s-0037-1615380
Zylberstein DE, Lissner L, Björkelund C, Mehlig K, Thelle DS, Gustafson D, Östling S, Waern M, Guo X, Skoog I. Midlife homocysteine and late-life dementia in women. A prospective population study. Neurobiology of ageing. 2011; 32(3):380-6. https://doi.org/10.1016/j.neurobiolaging.2009.02.024 PMid:19342123 DOI: https://doi.org/10.1016/j.neurobiolaging.2009.02.024
Amichai B, Shemer A, Grunwald MH. Low-dose isotretinoin in the treatment of acne vulgaris. Journal of the American Academy of Dermatology. 2006; 54(4):644-6. https://doi.org/10.1016/j.jaad.2005.11.1061 PMid:16546586 DOI: https://doi.org/10.1016/j.jaad.2005.11.1061
Sardana K, Garg VK, Sehgal VN, Mahajan S, Bhushan P. Efficacy of fixed lowâ€dose isotretinoin (20 mg, alternate days) with topical clindamycin gel in moderately severe acne vulgaris. Journal of the European Academy of Dermatology and Venereology. 2009; 23(5):556-60. https://doi.org/10.1111/j.1468-3083.2008.03022.x PMid:19143903 DOI: https://doi.org/10.1111/j.1468-3083.2008.03022.x
Yap FB. Safety and efficacy of fixedâ€dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia. Journal of cosmetic dermatology. 2017; 16(3):348-52. https://doi.org/10.1111/jocd.12268 PMid:27539948 DOI: https://doi.org/10.1111/jocd.12268
Hoţoleanu C, Porojan-Iuga M, Rusu ML, Andercou A. Hyperhomocysteinemia: clinical and therapeutical involvement in venous thrombosis. Romanian journal of internal medicine= Revue roumaine de medecine interne. 2007; 45(2):159-64.
Kamal M, Polat M. Effect of different doses of isotretinoin treatment on the levels of serum homocysteine, vitamin B 12 and folic acid in patients with acne vulgaris: A prospective controlled study. JPMA. The Journal of the Pakistan Medical Association. 2015; 65(9):950-953. PMid:26338739
Karadag AS, Tutal E, Ertugrul DT, Akin KO. Effect of isotretinoin treatment on plasma holotranscobalamin, vitamin B12, folic acid, and homocysteine levels: nonâ€controlled study. International journal of dermatology. 2011; 50(12):1564-9. https://doi.org/10.1111/j.1365-4632.2011.05027.x PMid:22098008 DOI: https://doi.org/10.1111/j.1365-4632.2011.05027.x
Roodsari MR, Akbari MR, Sarrafiâ€Rad N, Saeedi M, Gheisari M, Kavand S. The effect of isotretinoin treatment on plasma homocysteine levels in acne vulgaris. Clinical and Experimental Dermatology: Clinical dermatology. 2010; 35(6):624-6. https://doi.org/10.1111/j.1365-2230.2010.03778.x PMid:20236286 DOI: https://doi.org/10.1111/j.1365-2230.2010.03778.x
Schulpis KH, Karikas GA, Georgala S, Michas T, Tsakiris S. Elevated plasma homocysteine levels in patients on isotretinoin therapy for cystic acne. International journal of dermatology. 2001; 40(1):33-6. https://doi.org/10.1046/j.1365-4362.2001.00146.x PMid:11277950 DOI: https://doi.org/10.1046/j.1365-4362.2001.00146.x
Gökalp H, Bulur I, Gürer MA. Decreased vitamin B12 and folic Acid concentrations in acne patients after isotretinoin therapy: a controlled study. Indian journal of dermatology. 2014; 59(6):630. https://doi.org/10.4103/0019-5154.143533 PMid:25484410 PMCid:PMC4248518 DOI: https://doi.org/10.4103/0019-5154.143533
Javanbakht AM, Pour HM, Tarrahic MJ. Effects of oral isotretinoin on serum folic acid levels. Journal of drugs in dermatology: JDD. 2012; 11(9):e23-4. PMid:23135667
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Thanh Le Thai Van, Phuong Nguyen Minh, Phuong Tran Thi Thuy, Marco Gandolfi, Francesca Satolli, Claudio Feliciani, Micheal Tirant, Aleksandra Vojvodic, Torello Lotti
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0