The effect of continuous high versus low dose oral isotretinoin regimens on dermcidin expression in patients with moderate to severe acne vulgaris

The continuous low dose (LD) isotretinoin is frequently used in the treatment regimen for acne vulgaris. However, data about its antimicrobial are lacking. The present study aimed to investigate dermcidin expression and the effects of low and conventional dose isotretinoin on its expression in acne vulgaris patients. Skin dermcidin expression was investigated in 30 patients with moderate-severe acne vulgaris and 15 healthy control subjects using ELISA. 15 patients were given continuous low-dose isotretinoin (20 mg/day) and the other 15 given the conventional high dose (0.5 mg/kg/day). Skin biopsies were taken at the start of the study and 6 months later. Dermcidin was significantly lower in acne vulgaris patients (p <.001). Both isotretinoin regimens significantly raised dermcidin levels compared to pre-treatment values (p <.001). Relapse after 12 months was not statistically different among the two isotretinoin regimens (p =.464). Pretreatment global acne grading system score of 28.6 +/- 6.4 was reduced to 6 +/- 6.1 following isotretinoin treatment (p <.001). Relapse was significantly related to post-treatment dermcidin levels (p =.017). Dermcidin expression is reduced in acne vulgaris. Conventional and LD isotretinoin regimens are associated with increased dermcidin expression.