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Rheumatological symptoms due to retinoids
Bailliere'S Clinical Rheumatology
|April 1, 1991
Summary
Retinoids like isotretinoin and etretinate can cause skeletal side effects, primarily hyperostosis and enthesopathies, especially with long-term, high-dose use. These rheumatic symptoms are generally mild and do not hinder therapeutic use.
Area of Science:
- Dermatology
- Rheumatology
- Pharmacology
Background:
- Isotretinoin and etretinate are vitamin A derivatives used for keratinization disorders.
- Retinoids are associated with various side effects, including rheumatic symptoms.
Purpose of the Study:
- To review the skeletal and rheumatic side effects of retinoids.
- To assess the clinical significance and incidence of these adverse events.
Main Methods:
- Literature review of retinoid-induced skeletal and rheumatic syndromes.
- Analysis of reported cases and radiological findings.
Main Results:
- Hyperostosis (axial and peripheral) is the primary skeletal adverse reaction, occurring in over 80% with prolonged high-dose treatment.
- Musculoskeletal pain and arthralgias affect about 20% of patients.
- Other rare effects include periosteal proliferation, muscle damage, and vasculitis.
Conclusions:
- Retinoid-induced rheumatic syndromes are generally benign and manageable.
- Skeletal side effects, particularly hyperostosis, are common with long-term use but usually mild.
- These side effects should not preclude the therapeutic use of retinoids.