A comparative prospective study of the diagnostic index of acne and psychoemotional status in patients with moderate-to-severe acne during topical and systemic therapy with isotretinoin

Background. Acne vulgaris is a common chronic disease that impacts patients’ quality of life and psychoemotional status. Despite the existence of various therapeutic approaches, a comparative analysis of their effectiveness regarding psychological well-being remains relevant. Objective. To compare the dynamics of psychoemotional status and quality of life in patients with moderate-to-severe acne during topical and systemic isotretinoin therapy in combination with moisturizing care. Material and methods. An open-label, randomized, prospective study included 100 patients aged 18—25 years: group 1 (n=50) received systemic isotretinoin (0.4—0.8 mg/kg/day up to a cumulative dose of 100—120 mg/kg), group 2 (n=50) received topical retinoid. All patients were prescribed a moisturizer. Assessment (DIA, CADI, APSEA) was performed before, 4—5 and 8—10 months after the treatment. Results. Significant improvement was observed in the systemic therapy group. The DIA decreased from 10.8 (9.1; 12.5) to 1.9 (1.0; 3.0) points by the end of the follow-up (p<0.001), the CADI — from 11.5 (9.8; 13.2) to 2.8 (1.0; 4.0) points (p<0.001), the APSEA score — from 120 (108; 132) to 18 (10; 28) points (p<0.001). In the topical therapy group, the changes were statistically significant, but clinically moderate: the DIA decreased from 9.9 (8.5; 11.3) to 6.5 (5.0; 7.8) points (p<0.05), the CADI — from 11.0 (9.2; 12.8) to 7.8 (6.0; 9.5) points (p<0.05), the APSEA score— from 118 (110; 126) to 82 (70; 96) points (p<0.05). Conclusion. Systemic isotretinoin therapy in combination with corneotherapeutic care provides statistically significantly greater improvement in the clinical picture and psychoemotional status in patients aged 18—25 years with moderate-to-severe acne compared to topical therapy.