الفهرس 
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
A
cne is the most prevalent skin disease of adolescence and adulthood involving blockage and/or inflammation of pilo-sebaceous units (hair follicles and their accompanying sebaceous gland), (Delatti et al., 2018). It is a multifactorial inflammatory disease (Szepietowski et al., 2018).
Many factors affect individual patient acne treatment such as the type of acne, its severity, the patient’s ability to use the treatment and their psychological state (Hayashi et al., 2018). Oral isotretinoin therapy is one of the most efficacious therapies for the treatment of severe acne since its introduction in 1982. The usual course of isotretinoin lasts 16–24 weeks, with increasing amounts used as tolerated until the target dose, typically between 120 and 150 mg/kg, is reached (Lynn et al., 2016).
Oral isotretinoin may exert a significant change in baseline CBC, liver and/or lipid profile, (Vallerand et al., 2018). Since these changes may be dose-dependent and/or aggravated by the duration of treatment, basic serum laboratory investigations are monitored at baseline and monthly (Gencoglan et al., 2018). Our results show highly significant differences in ALT (p=0.004), AST (p=0.0001), TG (p=0.0001) and cholesterol (p=0.0002). These significance is particularly higher in cases received high dose of isotretinoin as regards post treatment AST, ALT, cholesterol and TG (p=0.004), (p=0.0001), (p=0.0001) and (p=0.0002), respectively when compared to low dose isotretinoin which showed significant differences as regards only AST and TG (p=0.002) and (p=0.001), respectively. Fortunately, the proportions of patients with laboratory abnormalities were low. The adverse effects can be treated without interrupting the treatment course unless, if laboratory results are above these close monitoring values (triglycerides >400 mg/d L, ALT >62 U/L, AST >80 U/L, cholesterol >300 mg/d L, WBC <2500) (Lee et al., 2016; Leelambika and Sarkar, 2016).
In addition to, hyperhomocysteinaemia is an independent risk factor of coronary artery diseases. It increases thrombogenicity, oxidative stress status and endothelial dysfunction (Schaffer et al., 2014). Our results showed highly significant difference in homocysteine level in acne patients (p =0.001), which is in accordance with other studies (Karadag et al., 2011; Muhammad and Muhterem, 2015 and Noor et al., 2018).
Few researches have been discussing the homocysteine levels in isotretinoin therapy (Muhammad and Muhterem, 2015; Noor et al., 2018). We report for the toxic effect of isotretinoin dose on homocysteine serum levels. Homocysteine showed significantly increased by isotretinoin treatment among all cases (p = 0.0001). Particularly, homocysteine serum level of in patient’s group who received high dose isotretinoin (1 mg/kg/d) showed highly significant results (p=0.02), in contrast to patient’s group who received low dose isotretinoin (0.5 mg/kg/d) i.e. the higher the dose the more the production of Homocysteine in serum.