Evaluation of low doses effect of systemic isotretinoin in monotherapy and combination on qualitative and quantitative composition of microbiota in patients with acne

Abstract

Objective. To evaluate the effect of low doses of systemic isotretinoin in monotherapy and combination on the qualitative and quantitative composition of the microbiota in patients with acne with moderate papulo-pustular acne.Materials and methods. 78 patients were monitored on an outpatient basis. Group 1 consisted of 38 patients. This group was divided into two age subgroups: A (12–24 years; n = 18) and B (25–45 years; n = 20). All patients in group 1 received monotherapy in the form of systemic administration of isotretinoin at a dose of 0.5–0.7 mg per 1 kg of body weight per day daily for 6 months. Group 2 consisted of 40 patients who were also divided into two age groups: A (12–24 years; n = 21) and B (25–45 years; n = 19). This group received combination therapy with isotretinoin at a dose of 0.1–0.3 mg per kg of body weight per day daily for 6 months in combination with phototherapy with broadband incoherent light (wavelength 440–950 nm) once every two weeks, a course of 4–6 procedures. To study the features of the qualitative and quantitative composition of the skin microbiota of acne patients, all patients were scraped and smeared with a sterile cotton swab before and after therapy, followed by analysis of microbial markers by chromatography-mass spectrometry.Results. Against the background of monotherapy in patients of different age groups, there was a positive dynamic in relation to the majority of microbiota indicators, its severity in subgroup A (12–24 years) was statistically more significant (p < 0.05). However, the complete normalization of the composition of the facial skin microbiota in both subgroups did not occur. After combination therapy, there was a pronounced positive dynamics and normalization of most indicators of the microbiota of the skin, regardless of age. However, the number of some targeted microorganisms turned out to be slightly higher than normal and after therapy.Conclusions. The use of low-dose isotretinoin monotherapy, as well as its combination with broadband incoherent light, does not allow to completely normalize the composition of the microbiota in patients suffering from acne papulo-pustular form of moderate severity, which requires further study and analysis.