Şiddetli Akne Vulgaris Hastaları ile Normal Popülasyonun İnflamatuar Belirteçlerinin Retrospektif Karşılaştırması

Öz

AMAÇ Bu çalışma, şiddetli akne vulgaris (AV) hastalarında sistemik inflamasyon indeksleri (SII, SIRI, AISI) ile hematolojik parametreleri sağlıklı bireylerle retrospektif olarak karşılaştırmayı amaçlamıştır. GEREÇ VE YÖNTEM Toplam 790 katılımcı çalışmaya dahil edildi; bunların 395’i orta-şiddetli AV hastası, 395’i ise sağlıklı kontroldü. Tıbbi kayıtlar retrospektif olarak incelendi. Nötrofil, lenfosit, monosit, trombosit düzeyleri, ortalama trombosit hacmi (MPV), ferritin, ortalama eritrosit hacmi (MCV), eritrosit dağılım genişliği (RDW), Sistemik İmmün Enflamasyon İndeksi (SII), Sistemik Enflamasyon Yanıt İndeksi (SIRI), Sistemik Enflamasyon Toplam İndeksi (AISI) ve MCV/RDW oranı değerlendirildi. BULGULAR AV grubunun yaş ortalaması anlamlı şekilde daha düşük, kadın oranı ise kontrol grubuna göre daha azdı (p<0.001). Nötrofil, lenfosit, monosit ve trombosit düzeyleri ile RDW değerleri AV grubunda anlamlı şekilde daha yüksekti (p<0.001). MCV/RDW oranı anlamlı olarak daha düşüktü (p=0.015). SII, SIRI ve AISI değerleri de hasta grubunda belirgin şekilde yüksekti (her biri için p<0.001). MPV, ferritin ve MCV değerlerinde ise anlamlı fark saptanmadı (p>0.05). TARTIŞMA Bulgular, AV ile sistemik enflamasyon arasında belirgin bir ilişki olduğunu göstermektedir. Nötrofil, lenfosit ve sistemik enflamasyon indekslerindeki artış, AV’nin sadece lokal bir deri hastalığı değil, altta yatan enflamatuvar aktiviteyi yansıtabilecek bir durum olabileceğini desteklemektedir. Ferritin ve MPV düzeylerinde AV grubu ile kontrol grubu arasında fark olmaması, literatürdeki bazı çalışmalarla uyumludur. MCV/RDW oranındaki düşüklük ise potansiyel bir tanı belirteci olabilir. SONUÇ Şiddetli AV hastalarında sistemik enflamasyon belirteçleri anlamlı şekilde artmıştır. Bu belirteçler hastalık aktivitesinin değerlendirilmesinde ve tedavi planlamasında yardımcı biyobelirteçler olarak kullanılabilir.

Anahtar Kelimeler

• akne vulgaris
• enflamatuvar belirteçler
• hematolojik belirteçler

Retrospective Comparison of Inflammatory Markers in Severe Acne Vulgaris Patients and Normal Population

Öz

AIM This study aimed to retrospectively compare systemic inflammatory indices and hematologic parameters in patients with severe acne vulgaris (AV) and healthy individuals. MATERIAL AND METHOD A total of 790 participants were included, consisting of 395 patients with severe AV and 395 healthy controls. Medical records were analyzed retrospectively. Inflammatory markers such as neutrophil, lymphocyte, monocyte, platelet counts, mean platelet volume (MPV), ferritin, mean corpuscular volume (MCV), red cell distribution width (RDW), Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI) and MCV/RDW ratio were recorded and analyzed. RESULTS The mean age of the AV group was significantly lower, and the proportion of females was lower compared to the control group (p<0.001). Neutrophil, lymphocyte, monocyte, and platelet counts, as well as RDW, were significantly higher in the AV group (p<0.001). The MCV/RDW ratio was significantly lower (p=0.015). Systemic inflammation indices (SII, SIRI, and AISI) were also significantly elevated in the AV group (p<0.001 for each). No significant differences were observed in MPV, ferritin, and MCV values (p>0.05). DISCUSSION The findings suggest a clear association between AV and systemic inflammation. Elevated levels of neutrophils, lymphocytes, and systemic indices reinforce the hypothesis that AV is not merely a localized skin condition but may reflect underlying inflammation. The lack of difference in ferritin and MPV values is consistent with some previous studies. The reduced MCV/RDW ratio in the patient group may have potential as a diagnostic marker. CONCLUSION Systemic inflammatory markers are significantly elevated in patients with severe AV, supporting their potential utility as auxiliary biomarkers in assessing disease activity and guiding treatment approaches.

Anahtar Kelimeler

• acne vulgaris
• inflammatory markers
• hematologic markers

Kaynakça

1. 1. Daye M, Temiz SA, Öztürk ENY, Işık B. Assessment of ELR, NLR, MPV, and CRP Levels in Patients With Acne Vulgaris. Cyprus J Med Sci. 2022 Apr;7(2):241-244. doi:10.4274/cjms.2021.2306.
2. 2. Akça HM, Tuncer Kara K. Investigation of the Relationship between Clinical Severity of Acne and Inflammatory Parameters in Patients with Acne Vulgaris. J Exp Clin Med. July 2023;40(2):205-210.
3. 3. Thodi NM, Peruvankuzhiyil F, Vasantha SC, Pulloor NK, Parambath NV. Analysis of C-reactive protein and ferritin as inflammatory marker and their association with the severity of COVID-19: a cross-sectional study. Natl J Lab Med. 2023;12(4):BO04–BO07. doi:10.7860/NJLM/2023/61486.2765
4. 4. İbiş S, Aksoy Saraç G, Akdağ T. Evaluation of MCV/ RDW Ratio and Correlations With Ferritin in Telogen Effluvium Patients. Dermatol Pract Concept. 2022;12(3):e2022151. Published 2022 Jul 1. doi:10.5826/dpc.1203a151
5. 5. Zhao E, Cheng Y, Yu C, Li H, Fan X. The systemic immune-inflammation index was non-linear associated with all-cause mortality in individuals with nonalcoholic fatty liver disease. Ann Med. 2023;55(1):2197652. doi:10.1080/07853890.2023.2197652
6. 6. Jiang S, Wang S, Wang Q, Deng C, Feng Y, Ma F et al. Systemic Inflammation Response Index (SIRI) Independently Predicts Survival in Advanced Lung Adenocarcinoma Patients Treated with First-Generation EGFR-TKIs. Cancer Manag Res. 2021;13:1315- 1322. Published 2021 Feb 15. doi:10.2147/CMAR.S287897
7. 7. Zinellu A, Collu C, Nasser M, Paliogiannis P, Mel- lino S, Zinellu E et al. The Aggregate Index of Systemic Inflammation (AISI): A Novel Prognostic Biomarker in Idiopathic Pulmonary Fibrosis. J Clin Med. 2021;10(18):4134. Published 2021 Sep 14. doi:10.3390/jcm10184134
8. 8. Digis M, Tosun M, Yasak Guner R, Akyol M. Effect of isotretinoin treatment on the inflammatory markers in patients with acne vulgaris: A case-control study. Turkiye Klinikleri J Dermatol. 2024;34(1):1-7.

9. 9. Moreno-Arrones OM, Boixeda P. The Importance of Innate Immunity in Acne. Importancia de la inmunidadinnata en el acné. Actas Dermosifiliogr. 2016;107(10):801-805. doi:10.1016/j.ad.2016.07.005 24
10. 10. Heng AHS, Chew FT. Systematic review of the epidemiology of acne vulgaris. Sci Rep. 2020;10(1):5754. doi:10.1038/s41598-020-62715-3
11. 11. Turkmen D, Altunisik N, Sener S. Investigation of monocyte HDL ratio as an indicator of inflammation and complete blood count parameters in patients with acne vulgaris. Int J Clin Pract. 2020;74(12):e13639. doi:10.1111/ijcp.13639
12. 12. Chen T, Chen Y, Shao X, Chen J, Liu L, Li Y et al. Hematological parameters in patients with acne. J Cosmet Dermatol. 2023;22(7):2099-2104. doi:10.1111/jocd.15676
13. 13. Duman N, Uzunali E, Manav V. A Comparative Study on Hematological Inflammation Markers in Acne Vulgaris. Int Blood Res Rev. 2015; 4 (4):1-5. doi: 10.9734/IBRR/2015/21905
14. 14. Mahroum N, Alghory A, Kiyak Z, Alwani A, Seida R, Alrais M et al. Ferritin -fromiron, through inflammation and autoimmunity, to COVID-19. J Autoimmun. 2022;126:102778. doi:10.1016/j.jaut.2021.102778
15. 15. Rashmi R, Yuti AM, Basavaraj KH. Enhanced ferritin/ iron ratio in psoriasis. Indian J Med Res. 2012;135(5):662-665.
16. 16. Katsaros M, Paschos P, Giouleme O. Red cell distribution width as a marker of activity in inflammatory bowel disease: a narrative review. Ann Gastroenterol. 2020;33(4):348-354. doi:10.20524/aog.2020.0486
17. 17. Alharbi NM, AlGhofaili FA, Alsaud JS, Asiri LM, Almutairi SM, Alruqayi DM et al. The Relationship Between Nutritional Anemia and Acne: A Case-Control Study. Cureus. 2023;15(5):e39109. Published 2023 May 16. doi:10.7759/cureus.39109
18. 18. Turan C, Metin N. A Novel Inflammatory Marker in the Follow-up of Moderate-to-Severe Acne Vulgaris Administered Isotretinoin: Systemic Immune-Inflammation Index (SII). Curr Health Sci J. 2022;48(1):63-67. doi:10.12865/CHSJ.48.01.09
19. 19. Turan C, Cosansu NC, Yuksekal G. The SII reflects inflammation in acne vulgaris, but fails to determine categorical severity. J Cosmet Dermatol. 2022;21(11):6385-6392. doi:10.1111/jocd.15301
20. 20. Cosansu NC, Yuksekal G, Turan U, Umitfer F, Yaldiz M, Sevimli Dikicier B. Investigation of systemic immune-inflammation index and systemic inflammation response index as an indicator of the anti-inflammatory effect of isotretinoin in patients with acne vulgaris. Cutan Ocul Toxicol. 2022;41(2):174-178. doi:10.1080/15569527.2022.2081700