Assessment of Plasma Malondialdehyde in Acne Patients on Isotretinoin Therapy

Abstract

Background Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit that affects predominantly adolescents and young adults. Oral isotretinoin is a highly effective treatment agent for patients with nodulocystic acne and moderate to severe acne resistant to conventional therapy, isotretinoin might have side effects of oxidative stress and lipid peroxidation. . Malondialdehyde is the end product of lipid peroxidation and is a good marker of free radical-mediated damage and oxidative stress. Objective The purpose of this study to estimate malondialdehyde level in patients on Isotretinoin treatment for moderate to severe acne and compare them with healthy control group. Patients and Methods The case-control study was conducted at Ain. Shams University Faculty of Medicine, Egypt, from October 2017 to April 2017, and comprised male or non-pregnant female patients more than 18 years of age. 88 participants were included in the study; 44 cases, categorized by the Global Evaluation Acne (GEA) into 22 patients with moderate acne vulgaris and 22 patients with severe acne in comparison to equal healthy matching group. Isotretinoin was started in a dosage of 0.5mg/kg/day, and1.0mg/kg/day in patients with moderate and severe acne vulgaris respectively. Malondialdehyde, liver function tests, lipid profile and CBC were tested at the baseline for all participants and after 3 months for the patients who started isotretnoin therapy. Results In the current study, the mean baseline level malondialdehyde among all cases was 141.39 µmo1/m1±88.90, (range: 34.5 -360) and in controls it was 40 [µmo1/m1 ±11.3, (range: 9.5-90.4) this difference was statistically highly significant (P = 0.001). There was highly significant difference in malondialdehyde serum level (p = 0.0001) among all cases after 3 months of isotretnoin therapy, also there was a significant increase in MDA serum level among moderate cases (p = 0.021) and highly significant increase of MDA in severe cases (p=.001).ALP, ALT, serum cholesterol and triglyceride significant increases were seen in all cases. Conclusion low dose isotretinoin seems to have less side effects on basic laboratory data such as CBC, liver function tests, lipid profile and Malondialdehyde serum levels than high dose.