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Santosh University Journal of Health Sciences


Use of Monoclonal Antibody KI-67 in Assessing the Effect of Oral Isotretinoin in Acne Vulgaris Patients


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Author Details: Rohini Pakhiddey, Shipra Paul, Ashish K. Mandal, Vijay Kumar

Volume : 1

Issue : 2

Online ISSN : 2455-1732

Print ISSN :

Article First Page : 60

Article End Page : 64


Abstract

 Introduction: Acne vulgaris is emerging as a disease of teenagers and young age group which can have serious psychosocial effect if untreated. It has been observed that increased proliferation of pilosebaceous duct keratinocytes leads to its blockage and hence, the development of acne. Ki-67, a nuclear marker expressed by actively cycling cells, has been employed as an operational marker of cell proliferation. Ki-67 can be used immunohistochemically to detect ductal hyper proliferation seen in clinical and subclinical acne lesions. Oral isotretinoin is being increasingly used in treatment of moderate to severe cases of acne vulgaris, the mechanism by which it exerts its action is quite debatable.
Aim: To study the effect of oral isotretinoin in the skin of acne vulgaris patients by using Ki-67.
Methods: Skin biopsy was procured from untreated patients of severe cases of acne vulgaris. Out of these, twenty histopathologically confirmed patients were included in the study. They were treated with oral isotretinoin in the dose of 0.5mg/Kg/day for 12 weeks, following which their skin biopsies were repeated. Immunostaining for Ki-67 was performed using rabbit monoclonal antibodies. Ki-67 index was calculated for the acne patients before and following treatment with oral isotretinoin. Statistical analysis was done using Wilcoxon Signed-Rank Test.
Result: Ki-67 positivity was seen in intrafollicular and interfollicular epidermis in all the 20 patients of acne (12 males and 8 females) before treatment. The Ki-67 index (mean ±SD) in these patients was higher in females (43.85 ±12.24) as compared to males (39.84± 6.98). The Ki-67 index (mean ±SD) in patients of acne after 12 weeks of treatment showed a reduction in both males and females (19.52± 5.60 and 21.15 ±5.2 respectively) as compared to acne patients before treatment. Statistically highly significant post-treatment reduction in Ki-67 index was seen in both male and female patients.
Conclusion: By using Ki-67 immunohistochemically, our study implicates that oral isotretinoin causes a reduction in proliferation of follicular and inter-follicular epidermal keratinocytes thereby, having a positive effect on acne skin.

Keywords
: Ki-67, Ki-67 index, Isotretinoin, Acne vulgaris