Musculoskeletal syndromes associated with acne

Area of Science:

• Dermatology
• Rheumatology
• Clinical Medicine

Background:

• Acne conglobata (AC), acne fulminans (AF), and isotretinoin-associated musculoskeletal syndromes are distinct clinical entities.
• Understanding their unique characteristics is crucial for accurate diagnosis and patient management.
• These syndromes involve complex interactions between skin conditions and systemic manifestations.

Purpose of the Study:

• To delineate the specific clinical features, demographic profiles, and key distinguishing factors of AC-associated, AF-associated, and isotretinoin-associated musculoskeletal syndromes.
• To provide a clear comparison of these three distinct conditions.
• To enhance diagnostic accuracy for clinicians managing acne patients with musculoskeletal complaints.

Main Methods:

• Comparative analysis of clinical case data.
• Review of patient demographics, presenting symptoms, and radiographic findings.
• Literature review focusing on established diagnostic criteria and observed patterns.

Main Results:

• AC-associated musculoskeletal syndrome predominantly affects black men over 22, presenting with sacroiliitis and peripheral arthropathy.
• AF-associated musculoskeletal syndrome primarily impacts white male teenagers, characterized by fever, weight loss, arthralgias, and osteolytic lesions (clavicle, sternum, long bones, ilium).
• Isotretinoin-associated musculoskeletal syndrome affects males and females equally, with common mild myalgias/arthralgias and occasional asymptomatic spinal hyperostotic lesions.

Conclusions:

• The three acne-related musculoskeletal syndromes exhibit distinct epidemiological and clinical profiles.
• AF-associated syndrome is uniquely identified by osteolytic bone lesions.
• Isotretinoin-associated musculoskeletal syndrome typically involves mild, transient symptoms, with hyperostotic changes in a subset of patients.