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Kapała J, Lewandowska J, Placek W, Owczarczyk-Saczonek A. Adverse Events in Isotretinoin Therapy: A Single-Arm Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116463. [PMID: 35682048 PMCID: PMC9180136 DOI: 10.3390/ijerph19116463] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Isotretinoin (ISO) is an oral prescription-only retinoid, well known for its acne-treating effect. However, it affects a substantial number of human cell types, causing a broad spectrum of adverse effects. The purpose of this study is to establish the isotretinoin therapy adverse events among human clinical trials and their prevalence. Two authors (J.K., J.L.) systematically performed the literature review and assessment from December 2021-February 2022. Three databases (PubMed, ClinicalTrials, and Cochrane Library) were searched using the following terms: "isotretinoin acne vulgaris" for published studies in English from 1980-2021. Finally, 25 randomized controlled clinical trials (RCTs) and five open-label clinical trials provided 3274 acne vulgaris suffering patients. Isotretinoin therapy affects almost all of the systems in the human body, causing numerous adverse events. However, they mainly concern mild mucocutaneous conditions (severe cases are rare) and represent individual responses to a drug. In addition, all adverse events are reversible and can be avoided by specific preparations.
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Affiliation(s)
- Jan Kapała
- Medical Faculty, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
- Correspondence:
| | - Julia Lewandowska
- Medical Faculty, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Waldemar Placek
- Department of Dermatology Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland; (W.P.); (A.O.-S.)
| | - Agnieszka Owczarczyk-Saczonek
- Department of Dermatology Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland; (W.P.); (A.O.-S.)
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Isotretinoin and neuropsychiatric side effects: Continued vigilance is needed. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6. [PMID: 37168254 PMCID: PMC10168661 DOI: 10.1016/j.jadr.2021.100230] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Isotretinoin (13-cis-retinoic acid, marketed under the names Accutane, Roaccutane, and others) is an effective treatment for acne that has been on the market for over 30 years, although reports of neuropsychiatric side effects continue to be reported. Isotretinoin is an isomer of the active form of Vitamin A, 13-trans-retinoic acid, which has known psychiatric side effects when given in excessive doses, and is part of the family of compounds called retinoids, which have multiple functions in the central nervous system. Methods The literature was reviewed in pubmed and psychinfo for research related to isotretinoin and neuropsychiatric side effects including depression, suicidal thoughts, suicide, mania, anxiety, impulsivity, emotional lability, violence, aggression, and psychosis. Results Multiple case series have shown that successful treatment of acne with isotretinoin results in improvements in measures of quality of life and self esteem However, studies show individual cases of clinically significant depression and other neuropsychiatric events that, although not common, are persistent in the literature. Since the original cases of depression were reported to the United States Food and Drug Administration, numerous cases have been reported to regulatory agencies in the United Kingdom, France, Ireland, Denmark, Australia, Canada, and other countries, making isotretinoin one of the top five medications in the world associated with depression and other neuropsychiatric side effects. Clinicians are advised to warn patients of the risks of neuropsychiatric side effects with isotretinoin which may arise from the medication itself, and not just as a side effect of acne or youth.
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3
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Aktaş Karabay E, Saltık ZA, Unay Demirel Ö. Evaluation of serum
FoxO1
,
mTORC1
,
IGF
‐1,
IGFBP
‐3 levels, and metabolic syndrome components in patients with acne vulgaris: A prospective case‐control study. Dermatol Ther 2020; 33:e13887. [DOI: 10.1111/dth.13887] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Ezgi Aktaş Karabay
- Faculty of Medicine, Department of Dermatology and Venereology Bahçeşehir University Istanbul Turkey
| | | | - Özlem Unay Demirel
- Faculty of Medicine, Department of Clinical Biochemistry Bahçeşehir University Istanbul Turkey
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4
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AlKhabbaz M, Al-Taiar A, Saeed M, Al-Sabah R, Albatineh AN. Predictors of Acne Vulgaris among Adolescents in Kuwait. Med Princ Pract 2020; 29:310-317. [PMID: 31557755 PMCID: PMC7445669 DOI: 10.1159/000503711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/26/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The prevalence of acne vulgaris (AV) among adolescents in Kuwait has remained mostly unknown. This study aimed to estimate the prevalence of AV and its predictors among adolescents in Kuwait. SUBJECTS AND METHODS A cross-sectional study was conducted on 714 participants who were randomly selected from public schools using multistage cluster random sampling. The presence or absence of AV, as well as severity of AV, were assessed using the Global Acne Grading Scale. Data on risk factors and potential confounders were collected from the parents through a self-administered questionnaire, and from the adolescents by face-to-face interview. Weight and height were measured in a standardized manner. RESULTS Of 714 participants, 320 (44.8%; 95% CI 41.1-48.6%) self-reported AV. By clinical examination, AV was found among 479 (67.1%; 95% CI 63.5-70.5%) participants. Factors that were found to be significantly associated with AV in multivariable analysis were age, gender, nationality, and BMI categories. Females compared to males (adjusted prevalence ratio [APR] 1.16 [95% CI 1.05-1.25]; p = 0.006) and overweight or obese adolescents compared to normal weight (APR 1.15 [95% CI 1.02-1.26] and 1.14 [95% CI 1.02-1.23], respectively; p = 0.026) were more likely to have AV. None of the food items studied showed an association with AV in multivariable analysis. CONCLUSION The prevalence of self-reported AV seems to be lower than that reported in other settings, while the prevalence of AV by clinical examination resembles that reported in many other countries. BMI was the only modifiable risk factor associated with AV in multivariable analysis, and none of the food items studied was related to the presence or absence of AV in multivariable analysis.
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Affiliation(s)
- Mona AlKhabbaz
- Quality and Accreditation Directorate, Ministry of Health, Kuwait, Kuwait
| | - Abdullah Al-Taiar
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA,
| | - Marwa Saeed
- Mubarak Alkabeer Polyclinic, Ahmadi Health Area, Kuwait, Kuwait
| | - Reem Al-Sabah
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Ahmed N Albatineh
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
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5
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Abdelmaksoud A, Vojvodic A, Ayhan E, Dönmezdil S, Jovicevic TV, Vojvodic P, Lotti T, Vestita M. Depression, isotretinoin, and folic acid: A practical review. Dermatol Ther 2019; 32:e13104. [PMID: 31587447 DOI: 10.1111/dth.13104] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/26/2019] [Indexed: 01/18/2023]
Abstract
Isotretinoin (ISO) is a first-generation retinoid discovered in 1952 and approved by the FDA for the treatment of nodulocystic acne in 1982. The anti-inflammatory properties of ISO have found its use in disorders other than acne. ISO can create psychiatric problems, including depression and suicidal ideation. These neuropsychiatric problems are very similar to disorders secondary to hyperhomocysteinemia (HHcy), vitamin B12, and folic acid (vitamin B9) deficiencies. Given that previous literature suggested folate supplementation improved the efficacy of traditional antidepressant medications, clinicians may wish to consider folate supplementation for patients with depression or possible depressive symptoms, such as acne patients with genetic susceptibility. Brain-derived neurotrophic factor may be a cytokine-specific screening biomarker in immune-based antidepressive therapy.
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Affiliation(s)
- Ayman Abdelmaksoud
- Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Serbia
| | - Erhan Ayhan
- Department of Dermatology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Süleyman Dönmezdil
- Department of Psychiatry, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | | | - Petar Vojvodic
- Clinic for Mental Disorders "Dr Laza Lazarevic", Belgrade, Serbia
| | - Torello Lotti
- Department of Dermatology, University of Rome "G. Marconi", Rome, Italy
| | - Michelangelo Vestita
- Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.,Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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6
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Tsai TY, Hsieh TS, Yang TH, Wang HH, Lin RL, Huang YC. The effects of isotretinoin therapy on serum homocysteine, folate and vitamin B 12 levels in patients with acne: a meta-analysis and meta-regression. J Eur Acad Dermatol Venereol 2019; 34:e32-e34. [PMID: 31419342 DOI: 10.1111/jdv.15886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- T-Y Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - T-S Hsieh
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - T-H Yang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - H-H Wang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - R L Lin
- The Ronald O. Perelman Department of Dermatology, New York University, New York, NY, USA
| | - Y-C Huang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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7
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Kim HJ, Lee SM, Lee JS, Lee SY, Chung EH, Cho MK, Lee SH, Kim JE. Homocysteine, folic acid, and vitamin B12 levels in patients on isotretinoin therapy for acne vulgaris: A meta‐analysis. J Cosmet Dermatol 2019; 19:736-745. [DOI: 10.1111/jocd.13059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/11/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Hyun Jung Kim
- Department of Preventive Medicine Korea University College of Medicine Seoul Korea
| | - Seung Min Lee
- Department of Dermatology, Soonchunhyang University Seoul Hospital Soonchunhyang University College of Medicine Seoul Korea
| | - Jong Suk Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital Soonchunhyang University College of Medicine Cheonan Korea
| | - Sung Yul Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital Soonchunhyang University College of Medicine Cheonan Korea
| | - Euy Hyun Chung
- Department of Dermatology, Soonchunhyang University Cheonan Hospital Soonchunhyang University College of Medicine Cheonan Korea
| | - Moon Kyun Cho
- Department of Dermatology, Soonchunhyang University Seoul Hospital Soonchunhyang University College of Medicine Seoul Korea
| | - Sang Hoon Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital Soonchunhyang University College of Medicine Bucheon Korea
| | - Jung Eun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital Soonchunhyang University College of Medicine Cheonan Korea
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8
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Vigarios E, Comont T, Piroth M, Cougoul P, Sibaud V. Severe aphthous stomatitis secondary to vitamin B12 deficiency with isotretinoin therapy. JAAD Case Rep 2019; 5:563-565. [PMID: 31245522 PMCID: PMC6581977 DOI: 10.1016/j.jdcr.2019.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Emmanuelle Vigarios
- Department of Oral Medicine, Institut Claudius Regaud, Institut Universitaire du cancer Toulouse-Oncopole, Toulouse, France
| | - Thibault Comont
- Department of Internal Medicine, Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du cancer Toulouse-Oncopole, Toulouse, France
| | - Marie Piroth
- Department of Dermatology, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Pierre Cougoul
- Department of Internal Medicine, Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du cancer Toulouse-Oncopole, Toulouse, France
| | - Vincent Sibaud
- Department of Oral Medicine, Institut Claudius Regaud, Institut Universitaire du cancer Toulouse-Oncopole, Toulouse, France.,Department of Oncodermatology and Clinical Research Unit, Institut Claudius Regaud, Institut Universitaire du cancer Toulouse-Oncopole, Toulouse, France
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9
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Van TLT, Minh PN, Thuy PTT, Gandolfi M, Satolli F, Feliciani C, Tirant M, Vojvodic A, Lotti T. Efficacy of Oral Low-Dose Isotretinoin in the Treatment of Acne Vulgaris in Vietnam. Open Access Maced J Med Sci 2019; 7:279-282. [PMID: 30745980 PMCID: PMC6364726 DOI: 10.3889/oamjms.2019.094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Oral isotretinoin is an effective therapy for acne. However, isotretinoin can induce hyperhomocysteinemia and decreased serum folic acid level, which may be a risk for cardiovascular disease and thrombosis, as well as psychoses. Besides, many recent types of research emphasise the safety and effects of the low dose isotretinoin therapy. AIM: The aim of our study was to evaluate the effect of the low-dose isotretinoin on the plasma homocysteine and serum folic acid level in the Vietnamese population. METHODS: We conducted a longitudinal study to evaluate the effectiveness of the low-dose therapy on the plasma homocysteine and serum folic acid level of 52 acne patients after 6-8-week treatment at University Medical Center Ho Chi Minh City, Viet Nam. Patients had moderate-severe acne with the prolonged course, and most of them had a scar. RESULTS: With a low dose of oral isotretinoin (0.37 ± 0.11 mg/kg/day), after 6-8-week treatment, patients dropped the severity of disease, increased the plasma homocysteine level and decreased the serum folic acid level with significant differences in comparison to those before treatment. However, these changes do not exceed the normal range. CONCLUSION: In overall, low dose isotretinoin treatment had effectiveness in decrease the severity of disease and no increasing the plasma homocysteine level as well as the serum folic acid level.
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Affiliation(s)
- Thanh Le Thai Van
- Department of Dermatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Department of Plastic and Cosmetic Surgery, University Medical Center, Ho Chi Minh City, Vietnam
| | | | - Phuong Tran Thi Thuy
- Department of Dermatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | | | | | - Michael Tirant
- University of Rome G. Marconi, Rome, Italy.,Psoriasis Eczema Clinic, Melbourne, Australia
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
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10
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Correlations among insulin-like growth factor-1, homocysteine, vitamin B12, and folic acid plasma levels following isotretinoin therapy in acne vulgaris patients. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2018. [DOI: 10.1097/01.ewx.0000529795.14438.c1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Kang D, Shi B, Erfe MC, Craft N, Li H. Vitamin B12 modulates the transcriptome of the skin microbiota in acne pathogenesis. Sci Transl Med 2016; 7:293ra103. [PMID: 26109103 DOI: 10.1126/scitranslmed.aab2009] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Various diseases have been linked to the human microbiota, but the underlying molecular mechanisms of the microbiota in disease pathogenesis are often poorly understood. Using acne as a disease model, we aimed to understand the molecular response of the skin microbiota to host metabolite signaling in disease pathogenesis. Metatranscriptomic analysis revealed that the transcriptional profiles of the skin microbiota separated acne patients from healthy individuals. The vitamin B12 biosynthesis pathway in the skin bacterium Propionibacterium acnes was significantly down-regulated in acne patients. We hypothesized that host vitamin B12 modulates the activities of the skin microbiota and contributes to acne pathogenesis. To test this hypothesis, we analyzed the skin microbiota in healthy subjects supplemented with vitamin B12. We found that the supplementation repressed the expression of vitamin B12 biosynthesis genes in P. acnes and altered the transcriptome of the skin microbiota. One of the 10 subjects studied developed acne 1 week after vitamin B12 supplementation. To further understand the molecular mechanism, we revealed that vitamin B12 supplementation in P. acnes cultures promoted the production of porphyrins, which have been shown to induce inflammation in acne. Our findings suggest a new bacterial pathogenesis pathway in acne and provide one molecular explanation for the long-standing clinical observation that vitamin B12 supplementation leads to acne development in a subset of individuals. Our study discovered that vitamin B12, an essential nutrient in humans, modulates the transcriptional activities of skin bacteria, and provided evidence that metabolite-mediated interactions between the host and the skin microbiota play essential roles in disease development.
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Affiliation(s)
- Dezhi Kang
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Baochen Shi
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Marie C Erfe
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Noah Craft
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Huiying Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA. UCLA-Department of Energy (DOE) Institute for Genomics and Proteomics, Los Angeles, CA 90095, USA.
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12
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Abstract
Vitamin B12, also known as cobalamin, is a water-soluble vitamin that is important in the hematological and nervous systems, and it has a complex relationship with the skin. Altered cobalamin levels can lead to dermatological manifestations, which may indicate a deficiency or excess of this vitamin. The biochemistry and metabolism of cobalamin is complex, and diseases can be associated with alterations of this metabolic pathway. The cutaneous manifestations of cobalamin deficiency include hyperpigmentation (most commonly); hair and nail changes; and oral changes, including glossitis. Additionally, several dermatologic conditions, including vitiligo, aphthous stomatitis, atopic dermatitis, and acne are related to cobalamin excess or deficiency. The cutaneous complications of cobalamin therapy include acne, rosacea, and allergic site reactions, or anaphylaxis with cobalamin injections. As cobalt is a component of cobalamin, patients with cobalt sensitivity have been reported to have cutaneous manifestations when receiving cobalamin replacement therapy.
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13
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Gökalp H, Bulur I, Gürer M. Decreased vitamin B12 and folic Acid concentrations in acne patients after isotretinoin therapy: a controlled study. Indian J Dermatol 2014; 59:630. [PMID: 25484410 PMCID: PMC4248518 DOI: 10.4103/0019-5154.143533] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Oral isotretinoin treatment might influence the levels of vitamin B12 and folic acid. Aims and Objectives: The aim of this study is to compare vitamin B12 and folic acid levels in patients with moderate and severe acne vulgaris with those of the healthy control group and to investigate the effect of isotretinoin treatment on these vitamins. Materials and Methods: Patients who completed 6 months of isotretinoin therapy for moderate and severe forms of acne vulgaris and a control group consisting of healthy individuals between February 2011 and March 2012 were included in the study. Before isotretinoin therapy and at 6.- months of the therapy, serum vitamin B12 and folic acid levels were measured. In the healthy control group, vitamin B12 and folic acid levels were assessed only once. Results: In total, 120 patients with moderate and severe acne vulgaris who completed 6 months isotretinoin therapy and 100 healthy individuals who constituted the control group were included in the study. Pre-treatment vitamin B12 values of the patient group were found to be statistically significantly higher (P = 0.002), but any statistically significant difference was not detected in folic acid measurements (P = 0.566). A statistically significant decrease was detected in post-treatment vitamin B12 and folic acid levels (P < 0.05). Conclusion: Vitamin B12/folic acid treatment should be given under medical surveillance before and during isotretinoin therapy. Supplementation of these vitamins should be recommended in cases of their deficiency, so as to decrease the risks of neuropsychiatric and occlusive vascular diseases.
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Affiliation(s)
- Hilal Gökalp
- Department of Dermatology, Malatya Government Hospital, Malatya, Turkey
| | - I Bulur
- Department of Dermatology, Ahi Evran University, Faculty of Medicine, Kırşehir, Turkey
| | - Ma Gürer
- Department of Dermatology, Gazi University, Faculty of Medicine, Ankara, Turkey
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14
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Gillbro JM, Al-Bader T, Westman M, Olsson MJ, Mavon A. Transcriptional changes in organoculture of full-thickness human skin following topical application of all-trans retinoic acid. Int J Cosmet Sci 2014; 36:253-61. [PMID: 24697191 PMCID: PMC4265278 DOI: 10.1111/ics.12121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 02/09/2014] [Indexed: 12/28/2022]
Abstract
Objective Retinoids are used as therapeutic agents for numerous skin diseases, for example, psoriasis, acne and keratinization disorders. The same substances have also been recognized in the treatment for hyperpigmentation disorders such as melasma. Other studies on photo-damaged skin have shown that retinoids reduce wrinkles, surface roughness, mottled pigmentation, and visual skin appearance as a whole. We tested the hypothesis that an organoculture of full-thickness human skin could be used as a preclinical model to investigate the retinoid transcriptional profile in human skin in vitro. Methods Full-thickness skin explants were exposed to topically applied all-trans retinoic acid (RA) for 24 h. The gene expression profile was analysed using oligonucleotide microarrays, and data were validated with real-time (RT) PCR. Results We showed that the expression of 93 genes was significantly altered more than twofold. Several of the altered genes, for example, KRT4, CYP26 and LCN2, have previously been shown to be affected by RA in keratinocyte monocultures, reconstructed epidermis and skin biopsies from patients treated topically or orally with RA. In addition, genes, such as SCEL, NRIP1, DGAT2, RDH12 EfnB2, MAPK14, SAMD9 and CEACAM6 not previously reported to be affected by RA in human skin, were identified for the first time in this study. Conclusion The results in the present study show that full-thickness human explants represent a valuable pre-clinical model for studying the effects of retinoids in skin. Résumé
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Affiliation(s)
- J M Gillbro
- Oriflame Skin Research Institute, Mäster Samuelsgatan 56, Stockholm, 11121, Sweden
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15
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Abstract
Drug-induced acne is a specific subset of acne that usually has some specific features, namely monomorphic pattern, unusual location of the lesions beyond the seborrheic areas, uncommon age of onset, a resistance to conventional acne treatment. Several drugs have been associated with the development of eruptions that may simulate acne vulgaris. However, so far, there are a few cases of vitamin B12-induced acne. We report a case of acneiform eruption induced by vitamin B12 injection in a 37-year-old female patient.
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Affiliation(s)
- Ilknur Balta
- Dermatology, Ministry of Health, Kecioren Training and Research Hospital , Ankara , Turkey and
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16
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Balta I, Ekiz O, Ozuguz P, Sen BB, Balta S, Cakar M, Demirkol S. Nutritional anemia in reproductive age women with postadolescent acne. Cutan Ocul Toxicol 2013; 32:200-3. [DOI: 10.3109/15569527.2012.751393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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