The Effect of Isotretinoin on Plasma Homocysteine Concentration of Patients with Acne Vulgaris

Isotretinoin (ISO) revolutionized the treatment of acne since 1980s and therafter, sever forms of acne have been treated more effectively, with less residual cosmetic or psychological damage. The use of Isotretinoin is associated with significant side-effects such as mucocutaneous involvement, dyslipidemia and increased liver enzymes. The aim of study was the evaluation of homocysteine (Hcy) levels and the responsible vitamins for its metabolism in patients with moderate to sever acne vulgaris undergone ISO treatment. Forty-seven (n=47) patients with acne, prepared with liver function tests, folate, vitamin B12, homocysteine and serum lipids evaluations. Hcy was evaluated before (Value 1) and on the 2nd month (value 2) of treatment with Isotretinoin (0.5 mg/kg/day), by HPLC methods. Hcy levels (value 1: 11.8 ±5.3 µmol/L vs. value 2: 13.6±7.4 µmol/L; P<0.001) were statically significantly increased in patients treated with ISO. In addition, lipids and liver enzymes increased in mentioned group. However, there was no significant correlation between Hcy levels, vitamins and liver enzymes. Elevated Hcy levels in patients after 2 months on ISO treatment might be resulted from liver function disturbances. Folate supplementation along with frequent evaluations of Hcy serum levels are strongly reconnnened for the prevention of a premature occlusive disease.