Isotretinoin-induced Spondyloarthropathy-related Symptoms: A Prospective Study

Acne vulgaris is a chronic inflammatory disease involving the pilosebaceous unit of the skin. Isotretinoin is a systemic retinoid that is often used as an effective treatment option for severe and treatment-resistant acne. Isotretinoin may also cause rheumatologic symptoms. The aim of this prospecti...

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Bibliographic Details
Published in:	Journal of rheumatology Vol. 42; no. 11; pp. 2106 - 2109
Main Authors:	Alkan, Samet, Kayiran, Nuriye, Zengin, Orhan, Kalem, Ali, Kimyon, Gezmis, Kilinc, Emine Ozkul, Pehlivan, Yavuz, Kirtak, Necmettin, Onat, Ahmet Mesut, Kisacik, Bunyamin
Format:	Journal Article
Language:	English
Published:	Canada 01-11-2015
Subjects:	Acne Vulgaris - diagnosis Acne Vulgaris - drug therapy Adolescent Age Distribution Cohort Studies Dose-Response Relationship, Drug Drug Administration Schedule Female Follow-Up Studies Humans Incidence Isotretinoin - adverse effects Isotretinoin - therapeutic use Male Prospective Studies Risk Assessment Severity of Illness Index Sex Distribution Spondylarthropathies - chemically induced Spondylarthropathies - epidemiology Spondylarthropathies - physiopathology Tetracycline - adverse effects Tetracycline - therapeutic use Young Adult ENTHESITIS INFLAMMATORY LOW BACK PAIN ISOTRETINOIN SPONDYLOARTHROPATHY
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Summary:	Acne vulgaris is a chronic inflammatory disease involving the pilosebaceous unit of the skin. Isotretinoin is a systemic retinoid that is often used as an effective treatment option for severe and treatment-resistant acne. Isotretinoin may also cause rheumatologic symptoms. The aim of this prospective observational study was to present followup results regarding the rheumatologic symptoms of patients who received systemic therapy for the treatment of acne (isotretinoin and tetracycline). For inclusion in the study, all consecutive patients with acne who were aged > 18 years were evaluated by the same dermatologist. The first 42 consecutive patients were included in the isotretinoin group, and after matching for age and sex, 32 consecutive patients were included in the tetracycline group. Isotretinoin treatment was planned as an average dose of 30 mg daily and a total dose of 120-150 mg/kg for 4-6 months. The patients were administered a dose of 1 g/day of tetracycline as 2 equal doses for 3 months. Forty-two patients diagnosed with acne vulgaris were treated with isotretinoin 20.6 ± 4.4 (male/female: 17/22), and 32 patients were treated with tetracycline 20.6 ± 2.7 (male/female: 8/24). There was no significant difference between the 2 groups with respect to age and sex. Unilateral Achilles enthesopathy developed in 3 patients, whereas both Achilles enthesopathy and unilateral sacroiliitis developed in 1 patient. Inflammatory back pain developed in 6 patients in the isotretinoin group. To our knowledge, this was the first prospective observational study that assessed the rheumatologic symptoms of isotretinoin treatment. The spondyloarthropathy findings were identified in 23.1% of the patients who used isotretinoin.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	0315-162X 1499-2752
DOI:	10.3899/jrheum.150013