Influence of Oral Isotretinoin Treatment on the Composition of Comedonal Lipids. Implications for Comedogenesis in Acne Vulgaris

Overview

Journal Arch Dermatol Res

Specialty Dermatology

Date 1988 Jan 1

PMID 2969220

Citations 9

Authors

B Melnik

T Kinner

G Plewig

Affiliations

Soon will be listed here.

Abstract

One of the primary events in the pathogenesis of acne vulgaris is abnormal follicular keratinization. Since oral isotretinoin therapy reduces follicular hyperkeratinization in acne, our study has been designed to determine whether epidermal lipid composition of the epithelium of sebaceous follicles is affected by isotretinoin treatment. Noninflamed early comedones obtained from ten patients with nodulocystic acne before and after the 6th week of isotretinoin therapy (mean daily dose 0.7 mg/kg b. wt.) were used as probes of the hyperkeratinizing follicular epithelium. Comedonal lipids were analyzed by high-performance thin-layer chromatography. Oral isotretinoin caused a decrease of the comedonal glyceride fraction by 36% (P less than 0.01), whereas free sterols and total ceramides increased by 34% (P less than 0.10) and 19%, respectively. The changes of comedonal lipids were associated with a significant elevation of the free sterols/cholesterol sulfate ratio of 86% from pretreatment levels (P less than 0.05). The isotretinoin-induced changes of the comedonal lipid composition in direction to a pattern of epidermal lipids of normal desquamating stratum corneum are discussed as a possible comedolytic mechanism of oral isotretinoin treatment.

Citing Articles

Isotretinoin treatment upregulates the expression of p53 in the skin and sebaceous glands of patients with acne vulgaris.

Agamia N, El Mulla K, Alsayed N, Ghazala R, El Maksoud R, Abdelmeniem I Arch Dermatol Res. 2022; 315(5):1355-1365.

PMID: 36585988 PMC: 10205870. DOI: 10.1007/s00403-022-02508-y.

Challenges and Solutions in Oral Isotretinoin in Acne: Reflections on 35 Years of Experience.

Bettoli V, Guerra-Tapia A, Herane M, Piquero-Martin J Clin Cosmet Investig Dermatol. 2020; 12:943-951.

PMID: 32021364 PMC: 6951028. DOI: 10.2147/CCID.S234231.

p53: key conductor of all anti-acne therapies.

Melnik B J Transl Med. 2017; 15(1):195.

PMID: 28927457 PMC: 5606086. DOI: 10.1186/s12967-017-1297-2.

Comparative study of oral isotretinoin versus oral isotretinoin + 20% salicylic Acid peel in the treatment of active acne.

Kar B, Tripathy S, Panda M J Cutan Aesthet Surg. 2014; 6(4):204-8.

PMID: 24470716 PMC: 3884884. DOI: 10.4103/0974-2077.123403.

Face to face with oral isotretinoin: a closer look at the spectrum of therapeutic outcomes and why some patients need repeated courses.

Del Rosso J J Clin Aesthet Dermatol. 2012; 5(11):17-24.

PMID: 23198008 PMC: 3509883.

References

Gershbein L, HAEBERLIN Jr J, Singh E . Composition of human comedone lipids. Dermatologica. 1970; 140(4):264-74. DOI: 10.1159/000252560. View

Elias P, Williams M, Maloney M, Bonifas J, Brown B, Grayson S . Stratum corneum lipids in disorders of cornification. Steroid sulfatase and cholesterol sulfate in normal desquamation and the pathogenesis of recessive X-linked ichthyosis. J Clin Invest. 1984; 74(4):1414-21. PMC: 425309. DOI: 10.1172/JCI111552. View

Plewig G, Gollnick H, Meigel W, Wokalek H . [13-cis retinoic acid in the oral therapy of acne conglobata. Results of a multi-center study]. Hautarzt. 1981; 32(12):634-46. View

Epstein E, Williams M, Elias P . The epidermal cholesterol sulfate cycle. J Am Acad Dermatol. 1984; 10(5 Pt 1):866-8. DOI: 10.1016/s0190-9622(84)80144-9. View

Stewart M, Grahek M, Cambier L, Wertz P, Downing D . Dilutional effect of increased sebaceous gland activity on the proportion of linoleic acid in sebaceous wax esters and in epidermal acylceramides. J Invest Dermatol. 1986; 87(6):733-6. DOI: 10.1111/1523-1747.ep12456856. View

Gomez E . Actions of isotretinoin and etretinate on the pilosebaceous unit. J Am Acad Dermatol. 1982; 6(4 Pt 2 Suppl):746-50. DOI: 10.1016/s0190-9622(82)70064-7. View

Downing D, Strauss J, POCHI P . Variability in the chemical composition of human skin surface lipids. J Invest Dermatol. 1969; 53(5):322-7. DOI: 10.1038/jid.1969.157. View

Strauss J, Stranieri A . Changes in long-term sebum production from isotretinoin therapy. J Am Acad Dermatol. 1982; 6(4 Pt 2 Suppl):751-6. DOI: 10.1016/s0190-9622(82)80055-8. View

Kligman A . An overview of acne. J Invest Dermatol. 1974; 62(3):268-87. DOI: 10.1111/1523-1747.ep12676801. View

10.

FARRELL L, Strauss J, Stranieri A . The treatment of severe cystic acne with 13-cis-retinoic acid. Evaluation of sebum production and the clinical response in a multiple-dose trial. J Am Acad Dermatol. 1980; 3(6):602-11. DOI: 10.1016/s0190-9622(80)80074-0. View

11.

Maloney M, Williams M, Epstein Jr E, Law M, Fritsch P, Elias P . Lipids in the pathogenesis of ichthyosis: topical cholesterol sulfate-induced scaling in hairless mice. J Invest Dermatol. 1984; 83(4):252-6. DOI: 10.1111/1523-1747.ep12340321. View

12.

ZELICKSON A, Strauss J, Mottaz J . Ultrastructural changes in open comedones following treatment of cystic acne with isotretinoin. Am J Dermatopathol. 1985; 7(3):241-4. DOI: 10.1097/00000372-198506000-00005. View

13.

Elias P . Epidermal lipids, barrier function, and desquamation. J Invest Dermatol. 1983; 80 Suppl:44s-49s. View

14.

Nicolaides N, Ansari M, Fu H, LINDSAY D . Lipid compsition on comedones compared with that of human skin surface in acne patients. J Invest Dermatol. 1970; 54(6):487-95. DOI: 10.1111/1523-1747.ep12259307. View

15.

Stewart M, Benoit A, Downing D, Strauss J . Suppression of sebum secretion with 13-cis-retinoic acid: effect on individual skin surface lipids and implications for their anatomic origin. J Invest Dermatol. 1984; 82(1):74-8. DOI: 10.1111/1523-1747.ep12259161. View

16.

Epstein Jr E, Williams M, Elias P . Steroid sulfatase, X-linked ichthyosis, and stratum corneum cell cohesion. Arch Dermatol. 1981; 117(12):761-3. View

17.

Yao J, Rastetter G . Microanalysis of complex tissue lipids by high-performance thin-layer chromatography. Anal Biochem. 1985; 150(1):111-6. DOI: 10.1016/0003-2697(85)90447-6. View

18.

Williams M, Elias P . Stratum corneum lipids in disorders of cornification: increased cholesterol sulfate content of stratum corneum in recessive x-linked ichthyosis. J Clin Invest. 1981; 68(6):1404-10. PMC: 370941. DOI: 10.1172/jci110391. View

19.

Downing D, Stewart M, Wertz P, Strauss J . Essential fatty acids and acne. J Am Acad Dermatol. 1986; 14(2 Pt 1):221-5. DOI: 10.1016/s0190-9622(86)70025-x. View

20.

Lester R, Schachter G, Light M . Isotretinoin and tetracycline in the management of severe nodulocystic acne. Int J Dermatol. 1985; 24(4):252-7. DOI: 10.1111/j.1365-4362.1985.tb05775.x. View