Comparison of the Effectiveness of Diet on the Systemic Immune-Inflammation Index in the Treatment of Acne Vulgaris With Isotretinoin

Abstract

Objective: Acne vulgaris is a systemic inflammatory disease. The consumption of milk and dairy products is considered a triggering factor in the etiopathogenesis of the disease. However, there is also evidence that milk and dairy products may reduce systemic inflammation. The systemic inflammatory development of isotretinoin, which is effectively used in the treatment of acne vulgaris, is controversial. The change in inflammation parameters during isotretinoin treatment with the use of milk and dairy products, which are triggers for acne, will facilitate understanding the effect of diet on the treatment of acne vulgaris. Materials and Methods: Sixty patients receiving systemic isotretinoin treatment for acne vulgaris were included in the study, and 30 patients were given a diet low in milk and dairy products in addition to their treatment. Results: When the values of all patients before treatment and at the 3rd month of treatment were examined, a decrease in neutrophil and lymphocyte counts and NLR, and an increase in platelet count and SII were observed, but these changes were not statistically significant. When intergroup changes were examined, no differences were observed in neutrophil, lymphocyte, and platelet counts or in SII and NLR values. Conclusion: A diet low in milk and dairy products has no effect on neutrophil, lymphocyte, and platelet counts or on SII and NLR values during the treatment of acne vulgaris.

Keywords

• diet
• milk
• NLR
• SII.

Akne Vulgarisin İzotretinoin ile Tedavisinde Diyetin Sistemik İmmün-İnflamasyon İndeksi Üzerine Etkinliğinin Karşılaştırılması

Abstract

Amaç: Akne vulgaris sistemik inflamatuar bir hastalıktır. Hastalığın etyopatogenezinde süt ve süt ürünlerinin kullanılması tetikleyici bir faktör olarak görülmektedir. Bununla birlikte süt ve sütürünlerinin sistemik inflamasyonu azaltabileceğine dair veriler de bulunmaktadır. Akne vulgarisin tedavinde etkin olarak kullanılan isotretinoinin sistemik inflamatuar gelişimi tartışmalıdır. Akne tetikleyicisi olan süt ve süt ürünlerinin kullanımı ile isotretinoin tedavisi sırasındaki inflamasyon parametrelerinin değişimi diyetin akne vulgaris tedavisi üzerine etkisini anlamayı kolaylaştıracaktır. Gereç ve Yöntem: çalışmaya akne vulgaris nedeni ile sistemik isotretinoin tedavisi alan 60 hasta dahil edilip 30 hastaya tedavilerine ek olarak süt ve süt ürünlerinden fakir diyet verilmiştir. Bulgular: Tüm hastaların tedavi öncesinde ve tedavinin 3. aydındaki değerleri incelendiğinde neutrofil ve lenfosit sayısının, NLR’nın azaldığı, trombosit sayısının ve Sİİ’nin arttığı izlendi ancak bu değişiklikler istatistiksel olarak anlamlı değildi. gruplar arası değişiklikler incelendiğinde neutrofil, lenfosit, trombosit sayılarında ve SII, NLR değerlerinde farklılık izlenmedi. Sonuç: süt ve süt ürünlerinden fakir beslenmenin akne vulgaris tedavisi sırasında neutrofil, lenfosit, trombosit sayılarında ve SII, NLR değerlerine etkisi bulunamamaktadır.

Keywords

• diyet
• NLR
• SII
• süt

References

1. Williams HC, Dellavalle RP, Garner S. Acne vulgaris. Lancet. 2012:28;379(9813):361- 72.
2. Bronsnick T, Murzaku EC, Rao BK. Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer. J Am Acad Dermatol. 2014 Dec;71(6):1039.e1- 1039.e12.
3. Holven KB, Gil A, Rangel-Huerta OD. Milk and Dairy Product Consumption and Inflammatory Biomarkers: An Updated Systematic Review of Randomized Clinical Trials. Adv Nutr. 2019: 1;10:239-50.
4. Yeh L, Bonati LM, Silverberg NB. Topical retinoids for acne. Semin Cutan Med Surg. 2016;35:50-6.
5. Brzezinski P, Borowska K, Chiriac A, Smigielski J. Adverse effects of isotretinoin: A large, retrospective review. Dermatol Ther. 2017;30(4).
6. Hareedy MS, Tawfik KM. Systemic isotretinoin has an impact on hemoglobin, ferritin, urea, ceruloplasmin, albumin, uric acid levels, and neutrophil to lymphocyte ratio in acne patients. J Cosmet Dermatol. 2022 ;21(11):6191-98.
7. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, Zhang X, Wang WM, Qiu SJ, Zhou J, Fan J. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014:1;20(23):6212- 22.
8. Dincer Rota D, Tanacan E. The utility of systemic-immune inflammation index for predicting the disease activation in patients with psoriasis. Int J Clin Pract. 2021 Jun;75(6):e14101.

9. Seçkin HY, Baş Y, Takçı Z, Kalkan G. Effects of isotretinoin on the inflammatory markers and the platelet counts in patients with acne vulgaris. Cutan Ocul Toxicol. 2016;35:89-91.
10. Demirbas A, Demirbas GU, Diremsizoglu E, Islamoglu G. Systemic Anti-Inflammatory Effects of Isotretinoin: Evaluation of Red Cell Distribution Width to Lymphocyte and Platelet Ratios as New Hematological Markers and Clinical Outcomes in Acne Vulgaris. J Cosmet Dermatol. 2025;24(3):e70108.
11. Turan Ç, Metin N. A Novel Inflammatory Marker in the Follow-up of Moderateto- Severe Acne Vulgaris Administered Isotretinoin: Systemic Immune-Inflammation Index (SII). Curr Health Sci J. 2022;48(1):63-67.
12. Zorlu Ö, Albayrak H, Aytekin S. Impact of oral isotretinoin on the inflammatory markers: can lymphocyte/HDL-C and platelet/ HDL-C ratios be new indicators of inflammation in acne vulgaris patients? Cutan Ocul Toxicol. 2024 ;43(4):383-9.
13. Çalık, M. N The Effect of Nutrition on Acne Vulgaris Turkish Journal of Health Sciences and Research 2023, 6.1: 52-62.
14. Ryguła I, Pikiewicz W, Kaminiów K. Impact of Diet and Nutrition in Patients with Acne Vulgaris. Nutrients. 2024:14;16(10):1476.
15. Bordoni A, Danesi F, Dardevet D, Dupont D, Fernandez AS, Gille D, Nunes Dos Santos C, Pinto P, Re R, Rémond D, Shahar DR, Vergères G. Dairy products and inflammation: A review of the clinical evidence. Crit Rev Food Sci Nutr. 2017:13;57(12):2497-2525.