The effect of systemic isotretinoin and doxycycline therapy on hematological parameters patients with acne vulgaris

Acne vulgaris is a chronic inflammatory skin disease frequently treated with systemic agents such as isotretinoin and doxycycline. Although these treatments are known to modulate inflammatory pathways, their short-term effects on hematological inflammatory indices remain unclear. This study evaluates changes in hematological inflammatory indices during isotretinoin and doxycycline treatment in patients with acne vulgaris.

This retrospective study included 237 patients with acne vulgaris treated with either isotretinoin (n = 125) or doxycycline (n = 112). Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were assessed at baseline, month 1, and month 2. Changes over time were analyzed using the Friedman test.

In the isotretinoin group, no significant changes were observed in NLR, PLR, MLR, SII, SIRI, or AISI values during the 2-month follow-up period (all p > 0.05). In the doxycycline group, a significant reduction in NLR was observed over time (Friedman χ² = 7.79, p = 0.020). No significant temporal changes were detected in PLR, MLR, SII, SIRI, or AISI values.

In this retrospective study, short-term isotretinoin treatment was not associated with significant changes in hematological inflammatory indices. Doxycycline treatment was associated with a reduction in NLR. These findings suggest that certain hematological indices may reflect short-term systemic inflammatory changes; however, the results should be interpreted cautiously, and further prospective studies are needed.