Inflammatory Back Pain in Patients Treated with Isotretinoin

To the Editor: Despite the positive effects of isotretinoin on a number of cancers and severe skin conditions, several disorders of the musculoskeletal system have been reported in patients who are treated with it. Reactive seronegative arthritis and sacroiliitis are very rare side effects1,2,3. We describe 4 cases of inflammatory back pain without sacroiliitis after a month of isotretinoin therapy. We observed that after termination of the isotretinoin therapy, patients’ complaints completely resolved. Musculoskeletal system side effects reported from isotretinoin treatment include skeletal hyperostosis, calcification of tendons and ligaments, premature epiphyseal closure, decreases in bone mineral density, back pain, myalgia and arthralgia, transient pain in the chest, arthritis, tendonitis, other types of bone abnormalities, elevations of creatine phosphokinase, and rare reports of rhabdomyolysis. Musculoskeletal symptoms are common with isotretinoin therapy, but sacroiliitis is a very rare adverse … Address correspondence to Dr. Y. Pehlivan, Gaziantep Universitesi Sahinbey Arastirma Hastanesi, Romatoloji BD, Gaziantep 27310, Turkey. E-mail: drpehlivan{at}hotmail.com