Evolution of skeletal hyperostoses caused by 13-cis-retinoic acid therapy

Effect of a single course of isotretinoin therapy on bone mineral density in adolescent patients with severe, recalcitrant, nodular acne

“…Radiographic hyperostosis is the most common observation in children treated for disorders of cornification. [5][6][7]20 Another study in patients undergoing long-term therapy for various dermatoses identified osteoporosis in patients treated with etretinate but not with isotretinoin. 13 Less clear are the effects on bone when the standard doses of isotretinoin are used in acne therapy.…”

Preventing and Managing the Side Effects of Isotretinoin

“…Those hyperostoses that appear the earliest become the largest over time. 53 In the typical acne patients treated for short durations (especially at low doses of 0.5 mg/kg/d), 54 hyperostoses are not clinically significant. After 5 years of treatment, hyperostotic changes are present in the majority of patients on isotretinoin but they are still most commonly asymptomatic.…”

Lack of Significant Skeletal Changes after Long-Term, Low-Dose Retinoid Therapy: Case Report and Review of the Literature

“…25 As with acitretin and etretinate, reports finding a positive association with skeletal abnormalities and isotretinoin found little association of radiographic abnormalities and symptoms. 10,27,[29][30][31][32] Despite numerous reports of an association of retinoids and radiologic changes, most studies have failed to link the radiology with symptoms or with the duration or dose of treatment. The occurrence of DISH syndrome, calcification of the ligaments, and osteoporosis in much of the aging population who are not on retinoid therapy makes interpretation of the literature a confusing task.…”