Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Medicine, University Hospital Ayr, Ayr, United Kingdom.
Dermatol Ther. 2018 Nov;31(6):e12715. doi: 10.1111/dth.12715. Epub 2018 Nov 5.
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.
持续低剂量 (LD) 异维 A 酸常被用于痤疮的治疗方案中。然而，关于其抗菌作用的数据尚缺乏。本研究旨在探讨皮脂抑素的表达以及低剂量和常规剂量异维 A 酸对痤疮患者皮脂抑素表达的影响。采用 ELISA 法检测 30 例中重度寻常性痤疮患者和 15 例健康对照者的皮肤皮脂抑素表达。15 例患者给予持续低剂量异维 A 酸（20mg/d），另 15 例患者给予常规高剂量（0.5mg/kg/d）。在研究开始和 6 个月后取皮肤活检。痤疮患者的皮脂抑素水平显著降低（p<0.001）。与治疗前相比，两种异维 A 酸方案均显著提高了皮脂抑素水平（p<0.001）。两种异维 A 酸方案治疗 12 个月后的复发率无统计学差异（p=0.464）。治疗前的全球痤疮分级系统评分 28.6±6.4 降至治疗后的 6±6.1（p<0.001）。复发与治疗后皮脂抑素水平显著相关（p=0.017）。痤疮患者的皮脂抑素表达降低。常规和 LD 异维 A 酸方案均与皮脂抑素表达增加相关。
