Objectives: Isotretinoin (ISO) has been used in the treatment of patients with severe acne vulgaris (AV) that is resistant to standard therapy with systemic antibiotics and topical agents, over the last few decades. The aim of this study was to investigate the relationship between ISO-induced musculoskeletal adverse effects and serum 25 hydroxy (OH) vitamin D levels.
Designs: 87 patients with AV who had musculoskeletal side effects due to ISO, included as adverse effect (AE) group. 90 patients with AV, without any adverse events associated with ISO, were recruited as control (C) group. Locomotor system examination of the participants was performed by the same clinician. Serum biochemistry parameters and 25 (OH) vitamin D levels were measured. Patients in the AE group were divided into three subgroups according to serum 25 (OH) vitamin D levels. Patients with serum 25 (OH) vitamin D level is lower than 10 ng/ml, was recruited as Group I, between 10-20 ng/ml, as Group II, higher than 20 ng/ml as Group III.
Results: AE and C groups were similar in aspect of age and gender (p >0.05). There was no statistically significant difference between these groups in terms of the mean serum vitamin D levels (p=0.17). Also, there was no significant difference between three subgroups in AE group, in terms of arthralgia (p=0.30), myalgia (p=0.29), low back pain (p=0.10) and sacroiliitis (p=0.17). In addition, there was no statistically significant correlation between the serum vitamin D levels and age, cumulative dose of ISO, arthralgia, myalgia and sacroiliitis parameters in AE group (p >0.05).
We found similar serum 25 hydroxy vitamin D levels between the AE and C groups and no significant difference in aspect of musculoskeletal adverse events in AE subgroups. We may conclude that vitamin D deficiency has no effect on the musculoskeletal adverse effects in patients using ISO for AV.