Effect of isotretinoin treatment on the inflammatory markers in patients with acne vulgaris: can monocyte/HDL be a new indicator for inflammatory activity of isotretinoin treatment?

Abstract

Background: Oral isotretinoin (ISO) can effect markers of inflammation in patients with acne vulgaris. To our knowledge, there are no data on the relationship between ISO and monocyte to HDL cholesterol ratio (MHR). In this study, it is aimed to examine the effect of the ISO treatment on the MHR and other inflammatory markers in patients with acne vulgaris.Materials and methods: In this study, 89 out of 120 patients with severe/very severe acne vulgaris according to the Global Acne Grading Scale who received at least 3 months of ISO treatment were evaluated. The complete blood counts including mean levels of mean platelet volume, plateletcrit (PTC), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), MHR, and serum biochemistry panel were evaluated before and after ISO treatment.Results: The mean platelet value, NLR, and PLR levels underwent a statistically significant decrease after ISO treatment (p < 0.05) while MHR increased significantly 3 months after ISO treatment (p = 0.017). The mean platelet value, NLR, and PLR levels were 9.56 ± 1.05, 2.15 ± 0.81, and 142.45 ± 48.33 before treatment while were 9.32 ± 1.45, 1.90 ± 0.99, and 127.94 ± 41.38 after treatment, respectively. On the other hand, MHR was 9.76 ± 4.27 and 10.86 ± 4.12 before and after treatment, respectively.Conclusions: In this study, we found that ISO may have both inflammatory and anti-inflammatory effects by using MPV, PTC, NLR, PLR, and MHR. The inflammatory effects of ISO may be associated with possible inflammatory diseases. MHR can be used as a novel marker to investigate the inflammatory effect of the ISO.