Acne Fulminans and Bilateral Seronegative Sacroiliitis Triggered by Isotretinoin

A Case With Bilateral Sacroiliitis and Polyneuropathy Development Due to Isotretinoin Use

“…In addition, development of sacroiliitis after systemic isotretinoin treatment was also reported in patients with SAPHO syndrome. 15,16 Dinçer et al 17 reported 3 also reported bilateral sacroiliitis and demyelinating polyneuropathy in a patient 20 years old, who used isotretinoin for three months (30 mg/day during first two months and 40 mg/day during last month). HLA-B27 positivity was detected in this case.…”

Isotretinoin-Induced Bilateral Sacroiliitis

“…The absence of fever and weight loss observed herein is possible in AF, such cases being reported under the name of 'acne fulminans sine fulminans ' [3]. Of note, induction of AF by isotretinoin has been described [1,2,[4][5][6]. …”

“…HLA-B27 antigen is not associated with any particular pattern of distribution of arthritis or osteitis including sacroiliitis or sacroiliacal pain in patients with AF, acne conglobata or SAPHO syndrome [2,7]. Finally in a few cases, isotretinoin precipitated AF [1,2,[4][5][6]. The increased fragility of the pilosebaceous duct induced by the drug could lead to a massive contact with P. acnes antigens.…”

“…Sacroiliitis is reported in 21% of AF patients with arthritis [2]. In a few cases, AF with sacroiliitis has been reported during isotretinoin treatment, suggesting the responsibility of the drug [6].…”

Inflammatory Back Pain in Patients Treated with Isotretinoin

“…Reactive seronegative arthritis and sacroiliitis are very rare side effects 1,2,3 . We describe 4 cases of inflammatory back pain without sacroiliitis after a month of isotretinoin therapy.…”