Acne, therapeutic effects of Mitoxantrone
Background Acne is one of the most common Dermatological diseases, usually afflicting young people as well as middle-aged ones. Specifically at the age range 40-50 years the frequency of occurrence is 3-5% mostly in men. In mild cases local types of treatment are usually sufficient. In chronic cases acne however, with therapy resistant, in spite of the plethora of new medications, the results are discouraging, necessitating thus the surgical solution. It was discovered, accidentally, that Multiple Scleroses (MS) patients under treatment with mitoxantrone presented additionally to their general amelioration an improvement in their acne condition. This, could lead one to believe an additional therapeutic possibility might exist. Method 1228 patients-728 male and 500 female with chronic progressive MS were examined in a period of six years. Of the 500 women twenty eight cases suffering by therapy resistant acne simultaneously were being examined every 3 months in the first years and every 6 months in the second year. In the first year period the patients received 80-100 mg Mitoxantrone. During this period the patients were being examined by a dermatologist and their condition was characterised as good-fair or with no improvement. These results were compared to the findings of the EDSS scale in these same patients. *8 male MS patients were not included in this sample because they did not meet the requirements set. Results 20 of the patients displayed a clear gradual improvement of their clinical acne condition. Another 6 patients presented a mild unstable improvement while two patients showed no therapeutic reaction. In the 26 patients who showed improvement with their acne condition there was a parallel improvement in their MS symptoms an average of -2,4 0.8 of the EDSS scale. The 2 patients who showed no improvement in the acne condition did not display any significant chages in the MS condition either. Discussion The appearence of the chronic resistant acne in the 28 female patients may have had an iatrogenic character (chronic use of cortizone). The improvement shown by these patients after their systematic treatment with Mitoxantrone for their MS condition, might be due to the known antimicrobial of this substance as well as its role in immunmodulated activity. It should be noted that the improvement was a long-term one, unlike the results of the treatments previously, undertaken with antibiotics or isotretinoid. The parallel improvement of general clinical MS condition of the patients with that of acne, should be attributed to the improvement of the immune system due to mitoxantrone. Further studies must be conducted on the Mitoxantrone use against acne given that at the doses used, no side-effects occured. Conclusion It is worth studying the therapeutic capabilities of Mitoxadrone in the chronic resistant acne cases
Abstract published in The Journal of INVESTIGATIVE DERMATOLOGY19;108(3)paper presented at the IV. International Dermatology Symposium Berlin, Sebaceous Gland, Acne and Related Disorders, Berlin, Germany, April 11-13 1997