The effect of low-dose isotretinoin therapy on serum androgen levels in women with acne vulgaris
© 2019 Published by Elsevier Inc. on behalf of Women's Dermatologic Society..
BACKGROUND: Acne vulgaris is a common dermatologic disease that causes significant social and psychological morbidity. Isotretinoin, as a vitamin A derivative, is the most effective agent in the treatment of acne. Evidence suggests that isotretinoin's therapeutic function is independent of hormonal mediation; however, the effect of isotretinoin on serum androgens and precursor androgen levels in humans remains unclear.
OBJECTIVE: Herein, we aim to investigate the effect of low-dose isotretinoin on androgen levels in women and postulate the role of concomitant anti-androgen therapy (e.g., spironolactone).
METHODS: A total of 36 women, age 18 to 30 years, with moderate-to-severe nodulocystic acne were treated with 20 mg isotretinoin (Roaccutane) daily for 3 months. A hormone panel was obtained at baseline and after completion of the treatment course. The panel included dehydroepiandrosterone (DHEA), 17-hydroxyprogestrone, testosterone, free testosterone, dihydrotestosterone (DHT), luteinizing hormone, follicle stimulating hormone, and prolactin.
RESULTS: Serum levels of testosterone (p = .015), prolactin (p = .001), and DHT (p = .001) were significantly decreased, while serum levels of DHEA (p = .001) significantly increased after isotretinoin treatment. No significant change was found in the other hormones evaluated.
LIMITATIONS: The distribution of acne was not assessed in our patient population. We did not directly evaluate for associations between elevated DHEA levels and clinical response rates.
CONCLUSION: Isotretinoin alone can decrease androgen levels, but increase an important driver of acne pathogenesis (i.e., DHEA). The co-administration of an anti-androgenic agent (e.g., spironolactone) may optimize the therapeutic efficacy of isotretinoin by limiting iatrogenic increases in DHEA and perhaps allow for more widespread use of low-dose isotretinoin.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
|---|---|
| Enthalten in: |
International journal of women's dermatology - 6(2020), 2 vom: 12. März, Seite 102-104 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Feily, Amir [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 13.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.ijwd.2019.10.007 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM308436229 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM308436229 | ||
| 003 | DE-627 | ||
| 005 | 20231225131733.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ijwd.2019.10.007 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1028.xml |
| 035 | |a (DE-627)NLM308436229 | ||
| 035 | |a (NLM)32258342 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Feily, Amir |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The effect of low-dose isotretinoin therapy on serum androgen levels in women with acne vulgaris |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 13.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2019 Published by Elsevier Inc. on behalf of Women's Dermatologic Society. | ||
| 520 | |a BACKGROUND: Acne vulgaris is a common dermatologic disease that causes significant social and psychological morbidity. Isotretinoin, as a vitamin A derivative, is the most effective agent in the treatment of acne. Evidence suggests that isotretinoin's therapeutic function is independent of hormonal mediation; however, the effect of isotretinoin on serum androgens and precursor androgen levels in humans remains unclear | ||
| 520 | |a OBJECTIVE: Herein, we aim to investigate the effect of low-dose isotretinoin on androgen levels in women and postulate the role of concomitant anti-androgen therapy (e.g., spironolactone) | ||
| 520 | |a METHODS: A total of 36 women, age 18 to 30 years, with moderate-to-severe nodulocystic acne were treated with 20 mg isotretinoin (Roaccutane) daily for 3 months. A hormone panel was obtained at baseline and after completion of the treatment course. The panel included dehydroepiandrosterone (DHEA), 17-hydroxyprogestrone, testosterone, free testosterone, dihydrotestosterone (DHT), luteinizing hormone, follicle stimulating hormone, and prolactin | ||
| 520 | |a RESULTS: Serum levels of testosterone (p = .015), prolactin (p = .001), and DHT (p = .001) were significantly decreased, while serum levels of DHEA (p = .001) significantly increased after isotretinoin treatment. No significant change was found in the other hormones evaluated | ||
| 520 | |a LIMITATIONS: The distribution of acne was not assessed in our patient population. We did not directly evaluate for associations between elevated DHEA levels and clinical response rates | ||
| 520 | |a CONCLUSION: Isotretinoin alone can decrease androgen levels, but increase an important driver of acne pathogenesis (i.e., DHEA). The co-administration of an anti-androgenic agent (e.g., spironolactone) may optimize the therapeutic efficacy of isotretinoin by limiting iatrogenic increases in DHEA and perhaps allow for more widespread use of low-dose isotretinoin | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Taheri, Tahere |e verfasserin |4 aut | |
| 700 | 1 | |a Meier-Schiesser, Barbara |e verfasserin |4 aut | |
| 700 | 1 | |a Rhinehart, Dena P |e verfasserin |4 aut | |
| 700 | 1 | |a Sobhanian, Saeed |e verfasserin |4 aut | |
| 700 | 1 | |a Colon-Diaz, Maricarmen |e verfasserin |4 aut | |
| 700 | 1 | |a Feily, Ahmad |e verfasserin |4 aut | |
| 700 | 1 | |a Ramirez-Fort, Marigdalia K |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of women's dermatology |d 2015 |g 6(2020), 2 vom: 12. März, Seite 102-104 |w (DE-627)NLM24776700X |x 2352-6475 |7 nnns |
| 773 | 1 | 8 | |g volume:6 |g year:2020 |g number:2 |g day:12 |g month:03 |g pages:102-104 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ijwd.2019.10.007 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 6 |j 2020 |e 2 |b 12 |c 03 |h 102-104 | ||