Vitamin D level in patients with moderate-to-severe acne: A case-control study combined with prospective study following oral isotretinoin treatment

Background: Vitamin D may have an important role in the pathogenesis of acne vulgaris (AV) as it has an immunomodulatory effect and regulates the proliferation and differentiation of keratinocytes. Oral isotretinoin used in the management of moderate-to-severe acne binds to the retinoid receptor which can form a heterodimer with vitamin D receptor (VDR) and may decrease the level of vitamin D by increasing catabolism. Two studies published so far investigating the effect of oral isotretinoin on serum vitamin D level are contradictory to one another.

Objective: This study aimed to compare the serum vitamin D levels in patients with moderate-to-severe acne and age- and sex-matched healthy controls and to determine the serum level of vitamin D in patients with moderate-to-severe acne following 3 months of oral isotretinoin treatment.

Methods: A total of 120 patients with moderate-to-severe acne and 90 age- and sex-matched healthy controls were enrolled in the study. The patients were treated with oral isotretinoin at 0.50-0.75 mg/kg/day and serum vitamin D was measured at baseline and 3 months after the treatment.

Result: Serum vitamin D was insufficient and deficient in 90.50% of cases in comparison with 43.33% of controls (p = 0.001). Serum vitamin D had an inverse correlation with the severity of acne. Following 3 months of oral isotretinoin, there was no significant change in serum vitamin D level (p = 0.127).

Conclusion: Vitamin D was low in patients with moderate-to-severe acne in compared with control. Vitamin D level did not change with short-term therapy with oral Isotretinoin.