The effect of systemic isotretinoin on systemic immune inflammation index, systemic inflammation response index and monocyte/high-density lipoprotein cholesterol ratio in patients with acne vulgaris

BACKGROUND: Systemic inflammation response index (SIRI), systemic immune inflammation index (SII), and monocyte/high-density lipoprotein (HDL) cholesterol ratio (MHR) have been used to determine the risk for systemic inflammatory diseases such as diabetes, cardiovascular diseases, and metabolic syndrome. We evaluated the effect of systemic isotretinoin on SII, SII, and MHR in acne patients.METHODS: Pre-treatment and 3-month post-treatment data of acne patients who received isotretinoin between November 2022-January 2024 were retrospectively reviewed.RESULTS: This study included 103 patients. A decrease in SIRI (P=0.042), SII (P=0.975), and MHR (P=0.086) was observed with treatment. Furthermore, a significant decrease in the serum neutrophil count (P=0.039), monocyte count (P=0.009), and HDL level (P=0.034), and an increase in platelet count (P=0.006) were detected after treatment.CONCLUSIONS: The decrease in SIRI, SII, and MHR indicates that isotretinoin effectively suppresses inflammation. Nevertheless, among these biomarkers, SIRI may be the most sensitive in assessing the effect of isotretinoin on inflammatory processes in acne. While the decrease in SIRI levels has a positive impact on cardiometabolic disease risk, the decrease in HDL levels is a negative factor. Moreover, changes in laboratory tests reveal that evaluation of complete blood count and HDL level may be useful in acne patients receiving isotretinoin.