Kotb Mamdouh Ali, Bin Dayel Salman, Abahussein Othman, Hussein Ramadan S
Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
Department of Dermatology, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
Medicine (Baltimore). 2025 Aug 29;104(35):e44236. doi: 10.1097/MD.0000000000044236.
Acne vulgaris (AV) is a common dermatological condition characterized by inflammatory and noninflammatory skin lesions. Isotretinoin (IOS), a systemic retinoid, is widely recognized for its efficacy in managing severe AV due to its potent anti-inflammatory and sebosuppressive properties. IOS interacts with nuclear receptors belonging to the steroid-thyroid hormone superfamily. While its therapeutic benefits are well-documented, the potential effects of IOS on thyroid function remain inadequately explored. This study aims to evaluate the impact of IOS therapy on thyroid hormone levels in patients with AV. This prospective study included 50 patients with AV who were prescribed 0.5 to 1 mg/kg/day of IOS treatment for 4 months. Thyroid function was evaluated by measuring serum levels of triiodothyronine, thyroid-stimulating hormone, and thyroxine at the beginning and post-IOS treatment period. Posttreatment analyses revealed a significant increase in thyroid-stimulating hormone levels and a substantial decrease in triiodothyronine and thyroxine levels compared to baseline measurements (P < .000). These findings suggest that IOS therapy may influence thyroid hormone synthesis and regulation. IOS may induce subclinical changes in thyroid function. Monitoring thyroid parameters during therapy is recommended. Further research with larger sample sizes and controlled designs is warranted to better understand the mechanisms underlying these associations and their clinical implications.
寻常痤疮（AV）是一种常见的皮肤病，其特征为炎性和非炎性皮肤损害。异维A酸（IOS）是一种全身性维甲酸，因其强大的抗炎和抑制皮脂分泌特性，在治疗重度AV方面的疗效广为人知。IOS与属于类固醇 - 甲状腺激素超家族的核受体相互作用。虽然其治疗益处有充分记录，但IOS对甲状腺功能的潜在影响仍未得到充分探索。本研究旨在评估IOS治疗对AV患者甲状腺激素水平的影响。这项前瞻性研究纳入了50例AV患者，他们被处方以0.5至1mg/kg/天的剂量接受IOS治疗4个月。在IOS治疗开始时和治疗后，通过测量血清三碘甲状腺原氨酸、促甲状腺激素和甲状腺素水平来评估甲状腺功能。治疗后分析显示，与基线测量相比，促甲状腺激素水平显著升高，三碘甲状腺原氨酸和甲状腺素水平大幅下降（P <.000）。这些发现表明IOS治疗可能影响甲状腺激素的合成和调节。IOS可能会引起甲状腺功能的亚临床变化。建议在治疗期间监测甲状腺参数。有必要进行更大样本量和对照设计的进一步研究，以更好地理解这些关联背后的机制及其临床意义。
