Effect of different doses of isotretinoin treatment on the levels of serum homocysteine, vitamin B 12 and folic acid in patients with acne vulgaris: A prospective controlled study.

OBJECTIVE To investigate the effects of different doses of isotretinoin on serum homocysteine, vitamin B12 and folic acid in patients with acne vulgaris. METHODS The case-control study was conducted at Gazi University School of Medicine, Ankara, Turkey, from November 2012 to March 2013, and comprised male or non-pregnant female patients more than 18 years of age. The cases had moderate to severe nodulocystic acne, while an equal and matching control group had healthy individuals. Isotretinoin was started in a dosage of 0.5 mg/kg/day, and 1.0 mg/kg/day in patients with medium and severe acne vulgaris respectively. Homocysteine, vitamin B12, folic acid, liver function tests, serum cholesterol and triglyceride levels were tested at the baseline and on day 45. SPSS 11 was used for statistical analysis. RESULTS The two groups had 62 subjects each. The cases had 47(76%) women and 15(25%) men with a group mean age of 21.0±2.7 years. The controls had 45(72.6%) women and 17(27.4%) men with a group mean age of 21.6±3.0 years. Homocysteine levels were significantly increased in both groups taking 0.5 mg/kg/day and 1.0 mg/kg/day isotretinoin (p<0.05). There were no statistically significant differences in the levels of vitamin B12, folate and liver function tests (p>0.05 each). Total cholesterol level increased significantly in the group using 1.0 mg/kg/day (p<0.05). In the triglyceride levels, significant increases were seen in both groups (p<0.05). CONCLUSIONS Evaluation of homocysteine, vitamin B12 and folic acid beside the routine tests were beneficial for the patients before they started isotretinoin treatment.