ABSTRACT

Objectives:

Isotretinoin is a synthetic vitamin A derivative that is highly effective in acne vulgaris. A few cases and cohort studies about sacroileitis due to isotretinoin have been reported recently. The aim in this study is to evaluate the prevalence of isotretinoin-induced sacroileitis in patients with acne vulgaris.

Materials and Methods:

Of the 468 acne vulgaris patients who were started on isotretinoin in the dermatology outpatient clinic, 99 patients who described back pain and/or morning stiffness associated with treatment and were referred to the rheumatology outpatient clinic were included in the study and reviewed retrospectively. Inflammatory low back pain (IBP) was evaluated using the Assessment of SpondyloArthritis International Society (ASAS) criteria by the same rheumatologist. Patients meeting ASAS criteria were evaluated with direct pelvis radiography and when necessary with sacroiliac joint magnetic resonance imaging (SIJ MRI).

Results:

Of the patients, 79 were female and the mean age of all patients was 19.8±3.6 years. The mean daily isotretinoin dose was 39.1±2.7 mg and the mean duration of treatment was 6.2±0.6 months. During isotretinoin treatment, mechanical low back pain was detected in 24.2% of the patients and IBP in 9.1%. There was no statistical difference in terms of mechanical low back pain and IBP frequency according to gender (p>0.05). The frequency of sacroileitis in SIJ MRI was determined as 4.04% (n=4). Unilateral sacroileitis was detected in 3 patients and bilateral sacroileitis in one patient. All patients with sacroileitis were female.

Conclusion:

In this study, the prevalence of isotretinoin-associated sacroileitis was emphasized based on abnormal physical examination findings. Although physical examination and detection of IBP are not very sensitive, they help the early detection of isotretinoin-induced sacroileitis. Acne vulgaris patients treated with isotretinoin should be evaluated for the development of sacroileitis, especially when they describe low back pain.

Keywords: Acne, Isotretinoin, Sacroileitis, Side Effect, Treatment

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Evaluation of the Prevalence of Sacroileitis in Acne Vulgaris Patients Treated with Isotretinoin

ABSTRACT

References