The impact of androgen levels on serum metabolic profiles in patients with polycystic ovary syndrome.

OBJECTIVE: This study aimed to investigate the impact of serum androgen levels on metabolic profiles in patients with polycystic ovary syndrome (PCOS). METHODS: We included 216 patients with PCOS and 216 healthy individuals selected as the control group. According to the measured serum androgen levels, patients with PCOS were divided into the hyperandrogenism group and non-hyperandrogenism group. Clinical metabolic indicators were assessed and compared between the two groups. Additionally, we assessed the correlation between androgen levels and clinical metabolic indicators. RESULTS: The body mass index, waist-to-hip ratio, mF-G score, and acne score, as well as T, LH, LSH/FSH, FPG, Cr, UA, TG, TC, and LDL-C levels were significantly higher in the PCOS group than in the control group. The incidence of hyperandrogenism and clinical hyperandrogenism in the PCOS group was significantly higher than that in the control group. Regarding clinical hyperandrogenism, hirsutism, acne, and acanthosis nigricans were significantly more common in the PCOS group than in the control group. Serum androgen levels were significantly correlated with the mF-G score, acne score, FSH, glucose concentration at 30 min, glucose concentration at 60 min, glucose concentration at 120 min, FINS, N120, HOMA-IR, HbA1c, AUCG, UA, TG, and hHDL-Clevels. CONCLUSION: Elevated serum androgen levels are commonly observed in patients with PCOS and are associated with multiple metabolic abnormalities. Therefore, it is recommended to regularly monitor glucose and lipid metabolism-related indicators in patients with PCOS who have elevated androgen levels.

The causal relationship between serum metabolites and acne vulgaris: a Mendelian randomization study.

In individuals with acne vulgaris, alterations occur in serum metabolite composition, yet the exact causal link between these metabolites and acne development remains elusive. Using genome-wide association datasets, we performed bidirectional Mendelian randomization (MR) to investigate the potential causal relationship between 309 serum metabolites and acne vulgaris. We performed sensitivity analysis to evaluate the presence of heterogeneity and pleiotropy. Forward MR analysis found 14 serum metabolites significantly associated with acne vulgaris, and reverse MR analysis found no significant association between acne vulgaris and these serum metabolites. Through validation using data from the FinnGen database of acne vulgaris studies, we found a conclusive and significant correlation between stearoylcarnitine and acne vulgaris. This provides new evidence in the search for new targets for the treatment of acne vulgaris.

Isotretinoin's Effect on Fasting Lipid Profile in Acne Patients.

OBJECTIVE: To determine the isotretinoin's effect on fasting lipid profile in patients with acne. STUDY DESIGN: Observational study. Place and Duration of the Study: Outpatient Department of Dermatology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan, from 22nd June to 21st December 2022. METHODOLOGY: Patients of clinically moderate and severe acne were selected and prescribed a dose of 0.5mg /kg cap isotretinoin for 6 months. They were advised to get a fasting lipid profile at the baseline and then after two months of isotretinoin therapy. National Cancer Institute Common Terminology Criteria for Adverse Events v5.0 grading system and Adult Treatment Panel III were used for the grading of abnormalities. McNemar Bowker test was used to assess the difference in variables [serum triglycerides (TGs), cholesterol, high-density lipoproteins (HDL), and low-density lipoproteins (LDL)] at the baseline and after 2 months follow-up. RESULTS: A total of 214 patients were evaluated. After 2 months of isotretinoin therapy, TGs and cholesterol levels were elevated to higher grade in 2% of the patients. Likewise in 1% of patients, LDL levels rised to higher grade. Moreover, HDL levels declined to lower grade in 2% of the patients taking isotretinoin. CONCLUSION: Insignificant alterations in the various serum lipid parameters were observed in acne patients during isotretinoin therapy. It is advisable to obtain a baseline fasting lipid profile in all acne patients on isotretinoin and repeated in those with baseline abnormal levels and in patients with a clinical sign of metabolic syndrome and a family history of dyslipidemias. KEY WORDS: Acne, Hyperlipidemias, Isotretinoin, Laboratory monitoring.

Prospective study of the effects of isotretinoin and vitamin D levels on severe acne vulgaris.

Background/aim: Acne vulgaris (AV) is a common inflammatory skin condition associated with psychological and social distress. Its pathogenesis involves factors such as sebaceous hypersecretion and Cutibacterium acnes colonization. Vitamin D plays a crucial role in the pathogenesis of various inflammatory skin disorders, including AV, due to its immunomodulatory effects and involvement in keratinocyte growth and maturity. However, adequate sun exposure is required for optimal vitamin D synthesis. Isotretinoin (IOS), a vitamin A derivative, is a commonly used medication for severe acne, acting by binding to retinoid receptors. It can also form heterodimers with vitamin D receptors, potentially increasing vitamin D catabolism. Previous studies examining the impact of oral IOS on serum vitamin D levels have yielded inconsistent results. Therefore, this study aimed to assess changes in 25-hydroxy (OH) vitamin D serum levels in individuals with severe AV before and after IOS treatment. Materials and methods: One hundred patients with severe AV were enrolled, each receiving 0.75 mg/kg IOS treatment daily for 4 months. Serum 25 OH vitamin D levels were measured before, during, and after treatment. Results: This study found a significant increase in serum 25 OH vitamin D levels among patients with severe AV following IOS treatment (p < 0.001). Conclusion: This study suggests that AV may negatively impact vitamin D synthesis, but IOS treatment appears to raise vitamin D serum levels in individuals with severe AV. Further research is needed to confirm the potential relationship between AV and vitamin D levels.

Excess Serum Interleukin-18 Distinguishes Patients With Pathogenic Mutations in PSTPIP1.

OBJECTIVE: Dominantly inherited PSTPIP1 mutations cause a spectrum of autoinflammatory manifestations epitomized by PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome.). The connections between PSTPIP1 and PAPA syndrome are poorly understood, although evidence suggests involvement of pyrin inflammasome activation. Interleukin-18 (IL-18) is an inflammasome-activated cytokine associated with susceptibility to macrophage activation syndrome (MAS). This study was undertaken to investigate an association of IL-18 with PAPA syndrome. METHODS: Clinical and genetic data and serum samples were obtained from patients referred to institutions due to symptoms indicative of PAPA syndrome. Serum IL-18, IL-18 binding protein (IL-18BP), and CXCL9 levels were assessed by bead-based assay, and free IL-18 levels were assessed by enzyme-linked immunosorbent assay. RESULTS: The symptoms of PSTPIP1-positive patients with PAPA syndrome overlapped with those of mutation-negative patients with PAPA-like conditions, but mutation-positive patients had earlier onset and a greater proportion had a history of arthritis. We found uniform elevation of total serum IL-18 in treated PAPA syndrome patients at levels nearly as high as those seen in NLRC4-associated autoinflammation with infantile enterocolitis patients, and well above levels found in most familial Mediterranean fever patients. Serum IL-18 elevation in PAPA syndrome patients persisted despite fluctuations in disease activity. Levels of the soluble IL-18 antagonist IL-18BP were modestly elevated, and PAPA syndrome patients had detectable free IL-18. PAPA syndrome was rarely associated with elevation of CXCL9, an indicator of interferon-γ activity, but no PAPA syndrome patients had a history of MAS. CONCLUSION: PAPA syndrome is a refractory and often disabling monogenic autoinflammatory disease associated with chronic and unopposed elevation of serum IL-18 levels but not with risk of MAS. These findings affect our understanding of the diseases in which IL-18 is overproduced and suggest a link between pyrin inflammasome activation, IL-18, and autoinflammation, without susceptibility to MAS.

Patterns of thyroid dysfunctions in adolescent patients suffering from severe acne during isotretinoin treatment.

Although oral isotretinoin has been widely used as a basic treatment of acne in adolescents, several studies have noted some alterations in thyroid functions during oral isotretinoin therapy. Therefore, the present study aims at evaluating the possible changes in thyroid-stimulating hormone (TSH), free thyroxin (fT4) and free triiodothyronine (fT3) levels during isotretinoin treatment and analyzing the possible factors which may contribute to such changes. In the present study, 47 patients received (0.5 mg/kg oral isotretinoin) for treatment of severe acne. TSH, fT4 and fT3 were measured at baseline, after 3 and 6 months. ANOVA tests were used for statistical analyses. The levels of fT4 and fT3 decreased significantly during isotretinoin treatment (from 0.85 ± 0.04 and 3.1 ± 0.26 at baseline to 0.81 ± 0.023 and 2.76 ± 0.2 after 6 months, respectively). The decrease was accompanied by significant elevation of TSH (0.66 ± 0.05 at baseline to 0.695 ± 0.05 after 6 months). The duration of therapy (but not the dose) has significantly affected all the hormonal changes. Previous incomplete or intermittent isotretinoin treatment had significantly influenced the changes in fT4 only, while gender affected the changes of TSH. Isotretinoin treatment can decrease fT4, fT3 and increase TSH. The pattern of these changes was affected by gender and previous isotretinoin therapy. Different doses of isotretinoin did not affect the hormonal changes, but the duration has been the major influencing factor.

ARTICLE: Advances in Oral Isotretinoin Therapy.

Since its approval in 1982, oral isotretinoin has revolutionized acne therapy. However, oral isotretinoin use has long been associated with challenges of variable bioavailability and food dependence. It is recommended to ingest oral isotretinoin with a high-fat meal in order to maximize absorption, but many patients fail to adhere to this recommendation. This may lead to inadequate isotretinoin absorption levels. Patients who fail to achieve isotretinoin target cumulative dose are more likely to experience symptom relapse. To address the challenge of traditional isotretinoin variable bioavailability, subsequent isotretinoin formulations have attempted to improve its absorption abilities. In 2014, an isotretinoin formulation utilizing Lidose technology, known as Absorica, showed significant improvements in absorption levels compared to traditional oral isotretinoin in the fasted state. In 2019, isotretinoin absorption levels were further advanced in a new formulation approved by the FDA known as Absorica LD. Utilizing advanced micronization technology that physically reduces the size of the drug molecule, Absorica LD exhibits twice the absorption levels of Absorica under fasting conditions. In the fed state, Absorica LD achieves similar plasma levels to Absorica with a 20 percent lower dose. Absorica LD also produces consistent serum isotretinoin levels irrespective of gastrointestinal contents. By eliminating the “food effect” seen in traditional oral isotretinoin, Absorica LD has the potential to improve patient adherence and long-term patient outcomes. J Drugs Dermatol. 20:5(Suppl):s5-11.

Effect of oral isotretinoin on muscle strength in patients with acne vulgaris: a prospective controlled study.

BACKGROUND: Musculoskeletal side effects related to isotretinoin are frequently reported. This study aimed to investigate the effect of oral isotretinoin treatment on muscle strength. Our second aim was to evaluate whether there was a correlation between the serum creatine phosphokinase (CPK) level, a specific marker of muscle breakdown, and muscle strength. METHODS: This study included 30 patients who presented to our hospital and were started on oral isotretinoin treatment for acne vulgaris and 30 patients in the control group who were given local treatment. Age, sex, height and weight of the patients were recorded, and the body mass index (BMI) was calculated. The hamstring and quadriceps muscle strengths of the non-dominant side were evaluated in all patients using an isokinetic dynamometer, and the peak torque (PT) values ​​were recorded. In the isotretinoin group, isokinetic measurements were performed again in those that completed six-month drug treatment and compared with the initial PT values. RESULTS: The two groups were similar in terms of age, sex, and BMI (p > 0.05). There was no significant difference between the isotretinoin and control groups in terms of muscle strength at the beginning of the treatment (p > 0.05). No significant change was observed in hamstring and quadriceps PT values in the isotretinoin group after 6 months of treatment compared to baseline (p > 0.05). No statistically significant correlation was found between the serum CPK level and hamstring and quadriceps muscle strength (p > 0.05). CONCLUSION: Oral isotretinoin doesn't alter muscle strength. There is no relationship between the serum CPK levels and muscle strength.

Dosages of androgenic hormones in adolescent patients with severe acne.

OBJECTIVE: Acne vulgaris in female adolescents, when severe or accompanied by other signs of androgenization, may represent a sign of hyperandrogenemia often underdiagnosed, which will have harmful consequences for adult life. The objective of this cross-sectional and retrospective study was to demonstrate the incidence of hormonal changes in the cases of female adolescents with severe or extensive acne, with or without other signs of hyperandrogenism, and propose a hormonal research pattern which should be indicated in order to detect early hyperandrogenemia. METHODS: The medical records of 38 female patients aged between 9 and 15 years old with grade II and/or III acne were analyzed. The dehydroepiandrosterone sulfate, dehydroepiandrostenedione, and androstenedione, total testosterone, and dihydrotestosterone sulfate hormones were required prior to initiation of treatment. The hormonal dosages were performed in the serum after at least 3 hours of fasting by means of radioimmunoassay tests. RESULTS: Of the 38 patients included, 44.7% presented changes in androgen levels (hyperandrogenemia), and the two most frequently altered hormones were DHEA and androstenedione, with the same incidence (23.6%). CONCLUSIONS: The correct and early diagnosis provides an effective and agile approach, including antiandrogen therapy, with the purpose of avoiding the reproductive and metabolic repercussions, besides controlling the inflammatory picture and avoid aesthetic complications.

Abnormal Baseline Lab Results Rarely Lead to Treatment Modification for Patients on Isotretinoin.

BACKGROUND: Treatment modification and clinical course for patients initiating isotretinoin with abnormal baseline lab results is currently unknown, and no recommendations exist for monitoring this patient group. METHODS: We performed a retrospective review of patients prescribed isotretinoin for acne from 2008 to 2016 at Brigham and Women's and Massachusetts General Hospitals to investigate the characteristics, clinical implications, and management of patients initiating isotretinoin for acne with baseline laboratory abnormalities. RESULTS: We identified a low rate (7.2%) of treatment modification, including interruption (3.6%) and early termination (3.6%), during isotretinoin therapy due to lab abnormalities for patients with baseline lab abnormalities. Abnormal baseline total cholesterol, triglyceride, and liver function tests did not predict management changes, as only 2 of 10 total treatment modifications were due to a lab result that was abnormal at baseline. Treatment modification was driven by ALT elevation not present at baseline that occurred in patients with liver comorbidities. CONCLUSION: Emphasizing relevant comorbidities, including hepatic disease or alcohol use, to inform our monitoring may be a superior predictor of abnormalities during treatment, as our work demonstrates that the value of baseline lab data prior to isotretinoin is unclear.

Can monocyte/HDL show inflammatory activity of isotretinoin treatment in acne patients?

Aim: There are reports that isotretinoin causes some important diseases such as teratogenicity, inflammatory bowel disease and sacroiliitis by triggering inflammation. (Monocyte/HDL (high density lipoprotein) ratio) MHR is closely related to inflammation and is thought to be an indicator of atherosclerotic development. We aimed to investigate how isotretinoin (ISO) affects the immunoinflammatory response in acne patients.Materials and Methods: In this study, 116 nodulocystic acne patients who received ISO treatment for at least three months were evaluated retrospectively. ISO treatment was given to patients at a dose of 0.5-1 mg/kg. Pre-treatment and post-treatment white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, mean platelet volume (MPV), platelet, plateletcrit, platelet distribution width (PDW), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), total cholesterol, LDL cholesterol, triglyceride, HDL cholesterol and MHR were evaluated.Results: MPV and MHR values were significantly increased after 3 month treatment (p < 0.05). There was no significant change in NLR and PLR values (p > 0.05). There was a significant decrease in neutrophil count (p < 0.05). There were no significant changes in WBC, lymphocyte, monocyte, platelet, plateletcrit values (p > 0.05). Total cholesterol, LDL cholesterol and triglyceride levels were significantly increased after three months of treatment (p < 0.05). HDL cholesterol levels decreased significantly after three months of treatment (p < 0.05).Conclusion: We concluded that ISO treatment may trigger inflammation due to the increase in MPV and MHR value. MHR can show inflammation after ISO treatment.

A study comparing the clinical and hormonal profile of late onset and persistent acne in adult females.

BACKGROUND: Adult acne has been classified into two major subtypes: "persistent acne" and "late onset acne". A surrogate marker of hyperandrogenism (HA) in adult female acne is the presence of clinical signs of HA and biochemical hyperandrogenemia. We compared the clinical and hormonal profiles of the two acne subtypes and evaluated the likely source of androgen excess - ovarian or adrenal. METHODS: Female acne patients 25 years of age and older were evaluated for clinical HA. Hormonal assessment included total testosterone (TT), sex hormone binding globulin (SHBG), free androgen index (FAI), anti-Mullerian hormone (AMH), 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), and prolactin. DHEAS and 17-OHP represented adrenal androgens and AMH indicated ovarian reserve. RESULTS: Of 120 cases, clinical HA was seen in 71.67% while biochemical hyperandrogenemia was detected in only 18.33% of patients. Though late onset was more common in adult acne patients (56.6%), the persistent acne subgroup (43.33%) had a younger age at onset, a past history of adolescent acne (51.92%), truncal predilection (44.23%), polycystic ovary syndrome (PCOS) (44.23%), significant presence of irregular menses (40.38%) and hirsutism (57.69%), and increased TT (13.46%), 17-OHP (76.92%), AMH (44.23%), and increased LH/FSH (15.38%) ratio. PCOS was seen more in the persistent acne patients with clinical HA and increased 17-OHP levels. CONCLUSION: Persistent acne patients had marked clinical HA, PCOS, and hormonal abnormalities necessitating an endocrinological evaluation. As a corollary, this subgroup would benefit from antiandrogen therapy.

Dosages of androgenic hormones in adolescent patients with severe acne

SUMMARY OBJECTIVE Acne vulgaris in female adolescents, when severe or accompanied by other signs of androgenization, may represent a sign of hyperandrogenemia often underdiagnosed, which will have harmful consequences for adult life. The objective of this cross-sectional and retrospective study was to demonstrate the incidence of hormonal changes in the cases of female adolescents with severe or extensive acne, with or without other signs of hyperandrogenism, and propose a hormonal research pattern which should be indicated in order to detect early hyperandrogenemia. METHODS The medical records of 38 female patients aged between 9 and 15 years old with grade II and/or III acne were analyzed. The dehydroepiandrosterone sulfate, dehydroepiandrostenedione, and androstenedione, total testosterone, and dihydrotestosterone sulfate hormones were required prior to initiation of treatment. The hormonal dosages were performed in the serum after at least 3 hours of fasting by means of radioimmunoassay tests. RESULTS Of the 38 patients included, 44.7% presented changes in androgen levels (hyperandrogenemia), and the two most frequently altered hormones were DHEA and androstenedione, with the same incidence (23.6%). CONCLUSIONS The correct and early diagnosis provides an effective and agile approach, including antiandrogen therapy, with the purpose of avoiding the reproductive and metabolic repercussions, besides controlling the inflammatory picture and avoid aesthetic complications.

RESUMO OBJETIVO A acne vulgar em adolescentes do sexo feminino, quando grave ou acompanhada de outros sinais de androgenização, pode representar um sinal de hiperandrogenemia muitas vezes subdiagnosticado, que acarretará consequências danosas para a vida adulta. O objetivo deste estudo transversal e retrospectivo foi demonstrar a incidência das alterações hormonais nos casos de adolescentes do sexo feminino com acne grave ou extensa, acompanhada ou não de outros sinais de hiperandrogenismo e propor um padrão de pesquisa hormonal que deve ser indicado com o intuito de detectar precocemente o quadro de hiperandrogenemia. MÉTODOS Foram analisados os prontuários de 38 pacientes do sexo feminino com idades entre 9 e 15 anos, portadoras de quadro de acne grau II e/ou III. Os hormônios sulfato de dehidroepiandrostenediona, dehidroepiandrostenediona, androstenediona, testosterona total e dehidrotestosterona foram solicitados antes do início do tratamento. As dosagens hormonais foram realizadas no soro após pelo menos 3 horas de jejum por meio de exames de radioimunoensaio. RESULTADOS Das 38 pacientes incluídas, 44,7% apresentaram alterações dos níveis de andrógenos (hiperandrogenemia), sendo que os dois hormônios mais frequentemente alterados foram o DHEA e androstenediona, com a mesma incidência (23,6%). CONCLUSÕES O diagnóstico correto e precoce propicia uma abordagem efetiva e ágil, incluindo a terapia antiandrogênica, com a finalidade de evitar as repercussões reprodutivas e metabólicas, além de controlar o quadro inflamatório e evitar complicações estéticas.

Serum YKL40: A novel potential link between inflammation and dyslipidemia in acne vulgaris.

BACKGROUND: Acne vulgaris (AV) is an inflammatory skin disorder that may be associated with metabolic disorders. The relation between lipid profile in acne is not widely investigated. Chitinase-3-like protein 1 (YKL-40) has been found to be implicated in different inflammatory conditions. AIMS: We aimed at investigating the role YKL-40 in acne pathogenesis and associated dyslipidemia in acne patients. PATIENTS/METHODS: This study included 50 acne vulgaris patients and 30 matched control subjects. Serum YKL-40 in addition to lipid profile were assessed in all studied subjects. RESULTS: Serum YKL-40 level was significantly elevated in acne patients than healthy controls (P < .001). We also found a significant positive correlations between serum YKL-40, serum TGs, TC, and LDL-C (P value: .022, .001, .017 respectively) while, a significant negative correlation between serum YKL-40 and HDL-c (P value: .036) was detected. CONCLUSION: Our study results suggest that YKL-40 might have a role in AV pathogenesis. In addition, it could provide a new potential link between inflammation and dyslipidemia observed in acne patients.

Serum TWEAK in acne vulgaris: An unknown soldier.

BACKGROUND: TWEAK is an inflammatory cytokine which is involved in the development of many inflammatory disorders. AIMS: This study aimed to evaluate serum levels of TWEAK in patients with acne vulgaris. SUBJECTS AND METHODS: This case-controlled study included 100 acne vulgaris patients divided into two groups. Group 1 included 25 patients with moderate acne and 25 patients with severe acne. Group 2 consisted of 50 acne-free control subjects. Acne was graded by the Global Acne Grading System (GAGS). Serum TWEAK was measured by ELISA kits. RESULTS: Acne patients had significant elevation in TWEAK serum levels when compared to the control subjects (P < 0.001). TWEAK serum levels did not show significant difference regarding disease grade, postacne scar, and hyperpigmentation (P value = 0.43, 0.37, 0.80, 0.67, respectively). TWEAK levels were not affected by any of the studied variables except for the significant negative correlation between its levels and the disease duration in severe acne group only (r = -0.42, P = 0.03). CONCLUSION: TWEAK may be involved in acne vulgaris development, but more studies are needed to clarify its role.

Homocysteine, folic acid, and vitamin B12 levels in patients on isotretinoin therapy for acne vulgaris: A meta-analysis.

BACKGROUND: Oral isotretinoin (Iso) is one of the most commonly used drugs for patients with moderate-to-severe acne; however, its use has been associated with several adverse effects. Some studies have suggested an association between Iso therapy and homocysteine (Hcy), folic acid, and vitamin B12 plasma levels. OBJECTIVE: To evaluate the changes in plasma Hcy, folic acid, and vitamin B12 levels during Iso therapy for acne using meta-analytic methods. METHODS: Five scientific databases (MEDLINE, EMBASE, Cochrane Library, SCOPUS, and Web of Science) were searched according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines up to December 2018. A review of 734 publications identified 10 studies that assessed plasma levels of Hcy, folic acid, and vitamin B12 during Iso therapy in acne patients. RESULTS: A total of 10 studies consisting of 592 patients were included in the meta-analysis. Plasma Hcy levels were significantly increased after Iso therapy (weighted mean difference [WMD]: 2.99, 95% confidence interval [CI]: 1.78-4.20, I2  = 86%), whereas folic acid levels were significantly decreased after Iso therapy (WMD: -1.03, 95% CI: -1.90 to -0.17, I2  = 89%). CONCLUSIONS: This meta-analysis found that Iso therapy was associated with changes in plasma levels of Hcy and folic acid in acne patients. However, further evaluation in controlled studies is needed to verify these results.

Plasma dermcidin levels in acne patients, and the effect of isotretinoin treatment on dermcidin levels.

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Dermcidin (DCD) is an antimicrobial peptide released from eccrine sweat glands and sebaceous glands. Studies investigating the role of DCD expression in acne development are scarce. The aim of this study was to determine the relationship between DCD expression and acne vulgaris and the effect of oral isotretinoin treatment on DCD levels. Two groups (one patient group and one control group) were included in the study. The patient group consisted of 30 patients with acne vulgaris who were given oral isotretinoin treatment for 6 months until the cumulative dose was attained. Plasma DCD levels were investigated before and 6 months after treatment. The control group comprised 30 volunteer individuals without acne vulgaris or any inflammatory dermatosis. Of the patients, 24 (80%) had Grade 3, 3 (10%) had Grade 1, and 3 (10%) had Grade 4 acne vulgaris, as determined according to the Pillsbury scoring method. The DCD levels in the control group were significantly higher than those in pretreatment patients (39.53 ± 20.2 vs. 28.60 ± 20.12, p = .004). Additionally, pretreatment DCD levels were significantly increased after 6 months of isotretinoin treatment in the patient group (28.60 ± 20.12 vs. 35.07 ± 24.02, p = .012). The mean pretreatment global acne grading system score of 20.86 ± 4.43 was decreased to 5.17 ± 1.91 in patients after treatment (p < .001). This study indicated that DCD plays an important role in the pathogenesis of acne. It demonstrates anti-inflammatory properties in acne vulgaris. Moreover, it was shown that isotretinoin treatment may improve acne vulgaris by increasing DCD levels.

[THE ROLE OF VITAMIN D IN THE DEVELOPMENT OF PSORIASIS AND ACNE].

The article discusses the role of vitamin D in the development of skin pathology - in particular, psoriasis and acne. In some publications the results of vitamin D sufficiency in patients with these diseases are cited, but there is still insufficient information to draw definitive conclusions about the role of vitamin D in their development. The aim of the study was to assess the role of vitamin D in psoriasis and acne development. The case-control study involved 66 people, including 20 patients with psoriasis (group 1), 20 with acne (group 2) and 26 healthy individuals (control group). All participants in the study were determined the level of plasma vitamin 25 (OH)D; in patients with psoriasis PASI index to determine the severity of the disease was calculated. Vitamin 25(OH)D deficiency was detected in a significant majority of patients with skin diseases, and its average plasma level in each group was significantly lower than in the control group. There was a correlation between vitamin 25(OH)D deficiency and psoriasis severity. In patients with psoriasis and acne, vitamin D preparations should be included in the treatment complex to increase the effectiveness of therapy.