isotretinoin and Tendinopathy

We present a patient in whom a combination of perinuclear antineutrophil cytoplasmic antibody-positive vasculitis, oligoarthritis, tendinitis, and myositis was considered to be associated with isotretinoin use. Discontinuation of the drug resulted in complete clinical and biochemical remission (normalization of perinuclear antineutrophil cytoplasmic antibody titer). Although we were unable to prove causality, no other underlying cause for the patient's course was found. We report this occurrence to bring it to the attention of physicians prescribing isotretinoin.

Topics: Acne Vulgaris; Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Antineutrophil Cytoplasmic; Arthritis; Dermatologic Agents; Diagnosis, Differential; Humans; Isotretinoin; Magnetic Resonance Imaging; Male; Myositis; Skin; Tendinopathy; Vasculitis; Withholding Treatment

Topics: Achilles Tendon; Adult; Humans; Isotretinoin; Male; Patella; Tendinopathy

We report three cases of acute Achilles tendonitis following administration of isotretinoin for acne vulgaris. In this rarely documented side-effect, the symptoms were intimately related to the isotretinoin therapy. Modification of dose regimes permitted control of the tendonitis and an eventual successful response to isotretinoin therapy. Oral isotretinoin has been in use for more than 10 years and is known to cause a wide variety of predictable side-effects the most common of which are cutaneous and dose related. Musculoskeletal problems are also well known to occur and these include myalgia, arthralgia and less commonly arthritis and muscle damage, however, isolated Achilles tendonitis has been reported on a rare and sporadic basis. We wish to report a series of three patients who developed acute Achilles tendonitis during administration of isotretinoin for acne.

Topics: Achilles Tendon; Acne Vulgaris; Acute Disease; Adult; Female; Humans; Isotretinoin; Male; Tendinopathy