Background: Acne vulgaris (AV) is a common inflammatory skin disorder. Systemic treatments like azithromycin and doxycycline are frequently used. The Angiotensin-Converting Enzyme (ACE) has been implicated in inflammation and skin diseases. This study investigated the association between ACE I/D polymorphism and therapeutic response to azithromycin versus doxycycline in moderate AV. Methods: This clinical trial enrolled 54 moderate AV patients divided equally into two groups: one received 100 mg/day doxycycline, the other 250 mg/day azithromycin for 3 months. DNA was extracted via salting-out method, and ACE I/D polymorphism was analyzed by PCR and electrophoresis. Treatment efficacy was assessed using Michelson's acne score and standardized photography. Post-treatment, genotype-phenotype correlations were evaluated. Results: The doxycycline group showed significantly higher recovery rates (59.3%) compared to azithromycin (18.5%) (p<0.001). However, no statistically significant association was observed between improvement percentages and genotypes in either the doxycycline ((P = 0.567) or azithromycin (P = 0.533) groups. Conclusion: Doxycycline was significantly more effective than azithromycin for moderate AV. However, no significant association was found between ACE I/D polymorphism and treatment response for either antibiotic. These findings guide therapeutic selection while suggesting that ACE genotyping may not predict treatment response in moderate AV.
Tavakolizadeh et al. (Thu,) studied this question.