We observed a fascinating case involving a 47-year-old man who developed a skin condition after starting vitamin B12 treatment for pernicious anemia. Just six weeks into his weekly injections of hydroxocobalamin, he experienced a sudden and widespread outbreak of inflammatory acne-like bumps on his face and trunk. This skin eruption was not only extensive but also caused significant itching and included comedones, commonly known as blackheads, particularly on his chest.
Upon closer examination, the medical team diagnosed him with a vitamin B12-induced acneiform eruption, which is different from typical acne vulgaris. This distinction came from several unique factors, including the patient's age, the sudden onset of the condition, and the presence of pruritus (itching) alongside a uniform type of lesions across non-seborrheic areas.
After normalizing his vitamin B12 levels, the hydroxocobalamin injections were stopped, and lymecycline—a type of antibiotic—was introduced. Remarkably, this led to a complete resolution of his skin lesions within three months. This case highlights how vitamin B12 can have an unusual, but significant impact on skin health, demonstrating that its effects are not just limited to its role in blood health but can extend into dermatological issues as well.
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We observed five notable cases of acneiform eruptions linked to vitamin B12 in women aged 21 to 62. These eruptions manifested between one week and five months after starting vitamin B12 therapy.
The primary symptoms consisted of papules and pustules appearing mainly on the face. In three of the patients, these skin issues also extended to areas like the neck, shoulders, chest, and upper back, but interestingly, there were no signs of comedones or cysts.
Out of the five women, two had particularly high levels of vitamin B12 in their blood. A closer look at one patient's skin under a microscope revealed eosinophilic folliculitis, a type of inflammation in hair follicles. Fortunately, all patients experienced spontaneous and complete recovery within three to six weeks after stopping vitamin B12 treatment.
Overall, while vitamin B12 did not provide a benefit for acne treatment, it highlighted an unusual side effect of acne-like symptoms in these cases.
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Tracnil™ improves acne in PCOSEfficacy and Safety of Tracnil™ Administration in Patients with Dermatological Manifestations of PCOS: An Open-Label Single-Arm Study.
Combination treatment complicates folate assessment
We evaluated the effectiveness of Tracnil™, a treatment combining myo-inositol, folic acid, and vitamin D3, specifically addressing acne in women with normal hormone levels who exhibit signs of polycystic ovary syndrome (PCOS). Conducting a single-arm study with 33 participants, we monitored acne symptoms, hirsutism, and menstrual irregularities over the course of eight weeks, along with hormone level assessments and safety evaluations.
Our findings suggested that Tracnil™ significantly reduced both inflammatory and non-inflammatory acne lesions. Additionally, it appeared to improve symptoms of hirsutism and help regulate menstrual cycles. While the exact mechanisms remain somewhat unclear, we believe that folic acid, in conjunction with the other components, plays a role in enhancing acne treatment responses, possibly by influencing receptor sensitivities to hormones.
Notably, throughout the study period, participants experienced minimal adverse reactions, and no severe side effects were identified. Even among those with normal hormonal levels, the combination therapy with myo-inositol and vitamin D3 underlined the potential benefits of Tracnil™ in managing dermatological signs associated with PCOS.
This research highlights the practicality of incorporating Tracnil™ into dermatological practice as a first-line approach for acne related to PCOS, broadening treatment options even in the absence of significant hormonal abnormalities.
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We've discovered that folate supplementation may play a role in managing musculoskeletal pain associated with isotretinoin, a medication commonly used for acne treatment. In our investigation involving six patients suffering from nodulocystic acne, we closely observed their experiences after starting isotretinoin. Each patient reported developing pain in their muscles and joints, a side effect that can significantly affect quality of life.
The patients were treated with daily doses of folic acid and vitamin B12, leading to successful pain relief. This suggests that these supplements could be beneficial in alleviating discomfort without halting the use of isotretinoin itself. It’s important to note that while our findings are promising, extensive trials with larger sample sizes are still necessary to confirm these results.
As we move forward, we encourage our peers to consider offering B12 and folate to patients experiencing musculoskeletal pain from isotretinoin. This could help maintain treatment effectiveness while addressing uncomfortable side effects. Our study sheds light on an important aspect of acne treatment and patient care, urging further investigation into the benefits of these vitamins for overall treatment satisfaction.
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Vitamin B12's unclear acne efficacySuccessful re-introduction of vitamin B12 after using isotretinoin to treat severe acne medicamentosa.
Study design limited effectiveness clarity
We explored the impact of reintroducing vitamin B12 in individuals who had undergone treatment with isotretinoin for severe acne, known as acne medicamentosa. This study aimed to examine whether vitamin B12 could help improve acne conditions after completing isotretinoin therapy.
Although we discussed the effects of vitamin B12, the study’s structure didn’t isolate it from other treatments, which might make it hard to gauge vitamin B12's full effectiveness on its own.
We observed that while vitamin B12 had some interaction in the treatment process, the overall conclusion about its significant benefits for acne remains unclear due to the lack of controlled conditions in the study design.
Therefore, while reintroducing vitamin B12 after isotretinoin treatment shows some potential, it does not provide strong enough evidence to confirm a notable impact on acne improvement alone.
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