Effects of isotretinoin on bone mineralization during routine therapy with isotretinoin for acne vulgaris.

OBJECTIVE

To examine the effects of isotretinoin on bone mineralization and other markers of calcium homeostasis in individuals receiving isotretinoin for routine therapy for severe acne vulgaris.

DESIGN

Cohort study.

SETTING

An academic medical center.

PATIENTS

Twenty individuals receiving isotretinoin for severe acne vulgaris.

INTERVENTION

None.

MAIN OUTCOME MEASURE

The primary outcome was the change in bone mineralization as measured by dual-energy x-ray absorptiometry of the lumbar spine and hip before and after isotretinoin therapy. Additional measurements included serum osteocalcin, calcium, 25-dihydroxyvitamin D, 1,25-dihydroxyvitamin D, and intact parathyroid hormone and urine hydroxyproline or calcium.

RESULTS

No changes were noted in bone mineralization of the lumbar spine or hip. Furthermore, no alterations were noted in serum measurements of osteocalcin, calcium, 25-dihydroxyvitamin D, intact parathyroid hormone, or urine measurements of hydroxyproline or calcium. A statistically significant change was noted in 1,25-dihydroxyvitamin D when serum from before and after isotretinoin therapy was compared.

CONCLUSION

The use of isotretinoin for 20 weeks for the treatment of severe acne vulgaris does not appear to have any substantial adverse effect on bone mineralization.