Role of in Acne and Effect of Isotretinoin on Expression.

Background: Nodulocystic acne is a severe type of acne that is known to improve after treatment with isotretinoin. Melnik has hypothesized a unifying concept on the mechanism of acne pathogenesis involving altered expression of Forkhead box O transcription factor () and role of isotretinoin in improving acne via modulating this pathway.

Aim: To evaluate the pathway proposed by Melnik in acne pathogenesis by analysing the difference in the expression of , peroxisome proliferator-activated receptor (), and androgen receptor (AR) between acne patients and non-acne controls and the effect of treatment with isotretinoin on change in expression of these genes in acne patients.

Results: The gene expression of was non significantly higher in acne patients as compared to controls. After treatment with isotretinoin, a significant decrease in expression in acne patients at mRNA ( = 0.05) level was observed. There was a significant decrease in grade 3 positivity of at protein level ( = 0.0009). A decrease in androgen receptor positivity ( = 0.055) at protein level was also observed.

Conclusion: Reduction in expression appears to be an important mechanism of action of isotretinoin in acne.