Comparing the Biochemical Effects of Oral Isotretinoin Vs Azithromycin in The Treatment of Moderate to Severe Acne Vulgaris

Abstract

Alaa Shawqi Abdulbari, Noor Mustafa Ali, Ahmed R. Abu Raghif, Nadheer A. Matloob

Background: The treatment selection in acne vulgaris (AV) is difficult due to challenging assessing severity; therefore, it should depend on a proper history, physical examination, previous treatment and response to treatment.
Aims: The aim of this study is to investigate the differences in sebum composition and skin pH in patients with moderate to severe acne vulgaris to identify lipid markers in comparison with the apparently healthy group and to study the effects of isotretinoin or azithromycin on the level lipid profile, liver enzymes, in addition to sebum composition.
Methods and Material: This study was conducted on sixty women patients with AV and thirty, apparently healthy individuals as a control group. The patients were allocated into two groups, A and B, group A was given 500 mg of azithromycin taken on alternative days for 3 months and group B was given 40mg/day isotretinoin for 3 months. Before and after therapy serum cholesterol, TG, ALP, ALT, GGT, creatinine additional to sebum cholesterol and squalene levels were measured. In the healthy control group, these parameters were assessed only once.
Results:The results of the study showed significant differences (p<0.05) in serum levels of cholesterol, TG, sebum cholesterol, Squalene and skin pH in patient group when compared to control group. A statistically significant increase was detected in isotretinoin group post-treatment liver enzymes, lipid profile and sebum cholesterol, while sebum squalene was a significant decrease. While the results detected there was no significant effect of azithromycin on TG concentration.
Conclusions: Both isotretinoin and azithromycin has side effects but isotretinoin has more effects on squalene concentration.