Microbiome changes in acne patients with celiac disease under different treatments

Abstract

Introduction. Systemic retinoids with a hepatotoxic effect and antibiotics affecting intestinal microflora are the first-line drugs in the treatment of moderate and severe acne. To prevent complications, it is necessary to search, develop and introduce into practice safe drug combinations, including drugs with a protective effect on intestinal microflora and liver. Objective. To study the effect of psyllium on tolerance and efficacy of systemic therapy with isotretinoin and doxycycline in patients with moderate acne having celiac disease. Material and methods. We examined 83 patients with celiac disease having moderate acne. They were randomized into two groups: group 1, receiving antibiotics (doxycycline), and group 2, receiving retinoid system (isotretinoin). Each group was divided into two subgroups A and B, depending on the reception of psyllium. Patients were followed up for 4 and 24 weeks, respectively. All patients received adjuvant topical therapy. Medical check-ups, biochemical blood and bacteriological stool analysis were done in each group before treatment and after the treatment. Results. In subgroup 1B (received psyllium) significant changes of intestinal microbiota were not observed during antibiotic treatment, in contrast to subgroup 1А, where severe intestinal dysbiosis was found. In subgroup 2A (without psyllium) carbohydrate metabolism disorder and lipid storage disease were noted on isotretinoin treatment, not being observed in subgroup 2B. Conclusion. Patients in both subgroups, who in addition to antibiotic and systemic retinoid treatment, received psyllium, showed better results of skin health, intestinal microbiome, general well-being, and quality of life.