Systemic isotretinoin for acne treatment: Ovarian reserve is safe with the low dose.

Isotretinoin is among the most frequently used medications in the dermatologic daily practice. With a Black box warning, teratogenicity is a major concern. Female fertility may be an issue to be investigated when it comes to its use in females. The aim of this work was to assess the effect of low dose isotretinoin on the ovarian reserve in female patients with moderate to severe acne. Sixty-sex female acne patients candidate for isotretinoin therapy and 66 controls were enrolled in this prospective controlled cohort study. Low dose isotretinoin (0.25-0.4 mg/kg/day) was given to the patients group for 6 months. Serum anti-Mullarian hormone (AMH), ovarian volume (OV) and Antral follicle count (AFC) were evaluated at baseline and 6 months after the last dose in the patients' group, and 1 year after the baseline assessment for the control subjects. There was no significant difference in serum AMH between patients after isotretinoin treatment and control subjects (p = 0.898). AMH failed to show any significant change in pre- and post- treatment levels in patients' group (p = 0.747). Both OV and AFC showed no significant changes in patient group when comparing pre- post- treatment levels on both sides (p > 0.05) and in control group between baseline and 1-year-interval levels on both sides (p > 0.05). Low-dose isotretinoin in treatment of moderate to severe acne seems to be safer on ovarian reserve as indicated by non-significant change in AMH levels as a sensitive parameter of female fertility.

Role of KLF2: New insight in inflammatory acne pathogenesis.

BACKGROUND: Acne is an inflammatory skin condition of pilosebaceous unit. Its pathogenesis is multifactorial with a central role of inflammatory and pro-inflammatory cytokines mediators. Downregulated Kruppel-like factor 2 (KLF2) leads to rapid secretion of many cytokines that are involved in acne pathogenesis. AIMS: This study aimed at evaluating the level of KLF2 mRNA, clarifying its role in acne pathogenesis and its relation to acne lesion type, degree of severity, and outcome. PATIENTS AND METHODS: The level of KLF2 mRNA was measured in 100 patients with acne and 50 age- and sex-matched healthy controls by using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: The value of KLF2 mRNA was lower in acne patients than control group (P < .001), being lowest in inflammatory acne group (grades III, IV, and V) than noninflammatory acne group (grades I and II) and highest in the control group (P < .001). KLF2 mRNA was decreased significantly with increased acne severity grade (P < .001). KLF2 mRNA was lower in cases healed by scars than those healed by postinflammatory hyperpigmentation. CONCLUSIONS: Decreased serum level of KLF2 is not only a claimed for AV pathogenesis but also a predictor for degree of acne severity and outcome.