The effect of continuous high versus low dose oral isotretinoin regimens on dermcidin expression in patients with moderate to severe acne vulgaris

Abstract

The continuous low dose (LD) isotretinoin is frequently used in the treatment regimen for acne vulgaris. However, data about its antimicrobial are lacking. The present study aimed to investigate dermcidin expression and the effects of low and conventional dose isotretinoin on its expression in acne vulgaris patients. Skin dermcidin expression was investigated in 30 patients with moderate–severe acne vulgaris and 15 healthy control subjects using ELISA. 15 patients were given continuous low‐dose isotretinoin (20 mg/day) and the other 15 given the conventional high dose (0.5 mg/kg/day). Skin biopsies were taken at the start of the study and 6 months later. Dermcidin was significantly lower in acne vulgaris patients (p < .001). Both isotretinoin regimens significantly raised dermcidin levels compared to pre‐treatment values (p < .001). Relapse after 12 months was not statistically different among the two isotretinoin regimens (p = .464). Pretreatment global acne grading system score of 28.6 ± 6.4 was reduced to 6 ± 6.1 following isotretinoin treatment (p < .001). Relapse was significantly related to posttreatment dermcidin levels (p = .017). Dermcidin expression is reduced in acne vulgaris. Conventional and LD isotretinoin regimens are associated with increased dermcidin expression.

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

“…Nakano et al () investigated the sweat concentration of DCD in patients with acne vulgaris and found lower DCD levels in acne patients than in healthy controls. El Aziz Ragab, Omar, Collier, El‐Wafa, and Gomaa () performed skin biopsies to detect DCD expression using ELISA in acne patients and healthy controls and reported decreased DCD levels in acne patients. In our study, we also found decreased plasma levels of DCD in acne patients than in healthy controls.…”

“…In a study by El Aziz Ragab et al, the effect of continuous low‐dose and conventional high‐dose isotretinoin treatment on DCD levels was examined in acne patients. It was noted that both regimens resulted in increased DCD levels (El Aziz Ragab et al, ). We also found that DCD levels were significantly increased after isotretinoin therapy in our patient group.…”

Low dose of isotretinoin: A comprehensive review

“…Dermcidin level was significantly low in the studied cohort of acne vulgaris patients and both isotretinoin regimens significantly raised dermcidin levels compared to pretreatment values. No significant difference in relapse rate over a 12‐month follow‐up period was noted among the two isotretinoin regimens (El Aziz Ragab, Omar, Collier, El‐Wafa, & Gomaa, ).…”

Depression, isotretinoin, and folic acid: A practical review

“…El Aziz Ragab et al noted that dermcidin was significantly lower in acne vulgaris patients. They noted that both ISO regimens (low‐dose ISO [20 mg/kg/day] and the conventional high dose [0.5 mg/kg/day]), significantly raised dermcidin levels compared to pretreatment values with no significant relapse after 12 months of follow‐up (El Aziz Ragab, Omar, Collier, El‐Wafa, & Gomaa, ). Lowering the treating dose of ISO may lessen the related neuropsychiatric adverse effects with optimum therapeutic efficacy compared to the standard dose.…”