Investigation of the Relationship between Clinical Severity of Acne and Inflammatory Parameters in Patients with Acne Vulgaris

Objective In this study, we investigated whether the Neutrophil /Lymphosite (N/L) ratio, mean platelet volume (MPV) value, GADS (The global acne rating system) score and other inflammatory parameters are related in acne vulgaris patients. Methods One-hundred acne patients, aged between 18–40 years, who treated at the Karaman Training and Research Hospital Dermatology Polyclinic between January and March 2022 were included in the study. Age, sex, duration of disease, medications and additional systemic diseases were recorded. Acne patients included in the study were tested for N/L ratio, erythrocyte sedimentation rate (ESR, mm/hr), C-reactive protein (hsCRP, mg/L), platelet count (PLT/L) and (MPV/FL). GADS scores calculated. Results There was a significant difference in ESR (p < 0.001) and CRP levels (p = 0.002) in patients with high GADS scores compared to those with low GADS scores .In all patients, the mean GADS score was 24.77 ± 11.00, and GADS scores were positively correlated with ESR and CRP levels. In our binary logistic regression analysis of age, sex, time, N/L ratio, PLT/L, MPV and ESR for identifying risk factors for severe acne vulgaris, the model explained 25.7% of high GADS scores. A high CRP level was identified as a risk factor for having a high GADS score. Conclusion In our study, we evaluated acne patients because it affects many age groups, is common, and sometimes causes extensive inflammation.

Keywords:

acne severity, inflammatory parameters inflammatory diseases, acne vulgaris,

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1. Kilkenny M, Merlin K, Young R et al. The prevalence of common skin conditions in Australian school students: 1. Common, plane and plantar viral warts. Br J Dermatol 1998;138: 840-45.
2. Zaenglain AL, Thiboutot DM, Acne vulgaris. In: Bolognia JL, Jorizzo JL, Schaffer Jv,editors. Dermatology. 3rd ed.Available at: http://expertconsultbook.com
3.Ozturk C, Balta S, Balta I et al. Neutrophil–lymphocyteratio and carotid-intima media thickness in patients with Behcet disease without cardiovascular involvement. Angiology 2014; 66: 291-96. Doi:10.1177/0003319714527638
4. Ma J, Kuzman J, Ray A, et al. Neutrophil-to-lymphocyte Ratio (NLR) as a predictor for recurrence in patients with stage III melanoma. SciRep 2018; 8:40-44. Doi:10.1038/s41598-018-22425-3
5. Akca HM, Tuncer Kara K. Correlation of urticaria activity score in chronic spontaneous urticaria with serum C-reactive protein level and neutrophil/lymphocyte ratio. Dermatol Ther. 2020 Nov 11:e14532. Doi: 10.1111/dth.14532.
6. Sandhaus LM, Meyer P. How useful are CBC and reticulocyte reports to clinicians? Am J ClinPathol 2002; 118(5): 787-93. Doi:10.1309/CQGG-HY0U-LRKL-GLMP.
7. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996; 7(2): 157-61.
8. Gasparyan AY, Ayvazyan L, Mikhailidis DP et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011; 17(1): 47-58. Doi:10.2174/138161211795049804
9. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A et al.. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-α therapy. Rheumatol Int. 2010; 30(8): 1125-9.
10. Yazici S, Yazici M, Erer B,et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volüme reflects disease activity. Platelets. 2010; 21(2): 122-5.
11. Doshi A, Zaheer A, Stiller M. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol 1997;36:416-8.
12. Thiboutot D, Gollnick H, Bettoli V et al. New insights into the management of acne: an update from the global alliance to improve outcomes in acne group. J Am Acad Dermatol 2009;60:1-50.
13. Gollnick H, Cunliffe W, Berson D et al. Management of acne: a report from a global alliance to improve outcomes in acne. J Am Acad Dermatol 2003;49:1-37.
14.Mohammed AIS, Mohammed GFAE, Younes S et al. Assessment of IL-12 Serum Level in Patients with Inflammatory Acne Vulgaris and its Correlation with its Severity. J Turk Acad Dermatol 2014;8(2):1482.
15. Wollheim FA. Markers of disease in rheumatoid arthritis. Curr Opin Rheumatol 2000; 12(3): 200-4.
16. Nakamura RM. Progress in theuse of biochemical and biological markers for evaluation of rheumatoid arthritis. J Clin Lab Anal 2000; 14(6): 305-13.
17.Namazi MR, Parhizkar AR, Jowkar F. Serum levels of hypersensitive-C-reactive protein in moderateand severe acne. Indian Dermatol Online J. 2015;6(4):253-7.
18.Pearson TA, Mensah GA, Alexander RW et al. Markers of inflammation and cardiovascular disease: Application to clinical and public health practice: A statement for health care professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107(3):499-511.
19. Ridker PM. Clinical application of C reactive protein for cardiovascular disease detection and prevention. Circulation 2003;107(3):363-9.
20. Bowman SJ. Hematological manifestations of rheumatoid arthritis. Scand J Rheumatol 2002; 31(5): 251-9.
21. Bertero MT, Caligaris-Cappio F. Anemia of chronic disorders in systemic autoimmune diseases. Haematologica 1997; 82(3): 375-81.
22. Ertenli I, Kiraz S, Ozturk MA et al.Pathologic thrombopoiesis of rheumatoid arthritis. Rheumatol Int 2003(2); 23: 49-60.
23. Nishimoto N. Interleukin-6 in rheumatoid arthritis. Curr Opin Rheumatol 2006; 18(3): 277-81.
24. Kara A, Guven M, Yilmaz MS et al. Are neutrophil, platelet and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? Eur Arch Otorhinolaryngol. 2018; 275:409-13.
25. Brown KM, Domin C, Aranha GV et al. Increased preoperative platelet count is associated with decreased survival after resection for adenocarcinoma of the pancreas. Am J Surg 2005;189(3): 278–282.
26. Topal U, Akyüz M, Sözüer EM et al. Diagnostic Value of Platelet/Lymphocyte Ratio in the Diagnosis of Acute Appendicitis and its Relationship with Age Turk J Colorectal Dis 2020;30(3):157-63.
27. Lehmann HP, Robinson KA, Andrews JS et al.Acne therapy: A methodologic review. J Am Acad Dermatol 2002;47:231 40.
28. Thiboutot D. Acne: 1991 2001. J Am Acad Dermatol 2002;47:109 17.