isotretinoin and Back-Pain

Isotretinoin has been reported to induce inflammatory back pain (IBP) and sacroiliitis in the patients with acne vulgaris. The aim of this study is to investigate the incidence of IBP and sacroiliitis in patients receiving isotretinoin treatment compared with oral antibiotics for acne vulgaris.. A total of 201 patients with moderate-to-severe acne vulgaris who received isotretinoin (n = 100) or oral antibiotics (n = 101) were included in the study. All patients were monthly questioned for IBP symptoms during their treatment. Patients described IBP were also evaluated for sacroiliitis by c-reactive protein, sedimentation rate, HLAB27, and sacroiliac magnetic resonance imaging (MRI). Isotretinoin was discontinued in all patients diagnosed as sacroiliitis, and these patients were reevaluated after 3 months.. IBP was observed in 21 (10.4%), and sacroiliitis was detected in 11 (11%) patients on isotretinoin treatment; in oral antibiotic group, we did not observe IBP or sacroiliitis. The incidence of IBP and sacroiliitis differed significantly between the isotretinoin and oral antibiotic groups (p < 0.0001, p = 0.02). Complete regression was observed in the great majority of patients following cessation of isotretinoin.. Our study is the largest prospective controlled study that investigated the incidence of sacroiliitis in patients receiving isotretinoin and compared with patients using oral antibiotics.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Back Pain; Dermatologic Agents; Humans; Isotretinoin; Prospective Studies; Sacroiliitis

We present the case of a 35-year-old man with thoracic back pain and stiffness, whose only medical history was cystic acne treated with repeated courses of retinoids. His thoracic spine was severely limited in range of movement and was found, on X-ray, to have unilateral hyperostosis typical of diffuse idiopathic skeletal hyperostosis (DISH)--an often asymptomatic condition rarely found in those under 50. Back stiffness in young patients with prolonged retinoid exposure should be investigated.

Topics: Acne Vulgaris; Adult; Analgesics; Back Pain; Dermatologic Agents; Diagnosis, Differential; Drug Administration Schedule; Humans; Hyperostosis, Diffuse Idiopathic Skeletal; Isotretinoin; Male; Radiography; Thoracic Vertebrae

Topics: Acne Vulgaris; Adult; Back Pain; Dermatologic Agents; Female; Humans; Inflammation; Isotretinoin; Male; Young Adult

We report on a young woman suffering from SAPHO syndrome with back pain and arthritis of the sternoclavicular joints. This inflammatory disorder of the osteoarticular system (synovitis, osteitis, and hyperostosis) is associated with severe acne or palmoplantar pustulosis. The patient was treated with pamidronate, NSAID and physiotherapy which improved the musculoskeletal symptoms completely. The acne was treated with isotretinoin.

Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Administration, Oral; Administration, Topical; Adult; Anti-Inflammatory Agents; Back Pain; Calcium Compounds; Combined Modality Therapy; Diagnosis, Differential; Diphosphonates; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Infusions, Intravenous; Isotretinoin; Naproxen; Pamidronate; Physical Therapy Modalities; Sulfides; Thiosulfates