Diffuse idiopathic skeletal hyperostosis and isotretinoin in cystic acne

(2015) Diffuse idiopathic skeletal hyperostosis and isotretinoin in cystic acne. BMJ Case Reports, 2015. ISSN 1757-790X

Text Attached standard file_ Zhao_Febuary_2015.pdf Access to this file is embargoed until UNSPECIFIED. Download (214kB)

Abstract

DISH and isotretinoin in cystic acne SUMMARY We present the case of a 35 year old male with thoracic back pain and stiffness, whose only past medical history was cystic acne treated with repeated courses of retinoids. His thoracic spine was severely limited in range of movement and was found to have unilateral hyperostosis on X-ray typical of Diffuse Idiopathic Skeletal Hyperostosis (DISH) – an often asymptomatic condition rarely found in those under 50. Back stiffness in young patients with prolonged retinoid exposure should be investigated. BACKGROUND Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a prevalent but mostly asymptomatic condition of the elderly, often not distinguished from osteoarthritis. It is poorly understood and management is symptomatic. Reports have associated it with prolonged use of retinoids, however this is not widely known. Use of retinoids for acne in the young has been increasing. Although back pain is common and should not be over investigated, this case raises awareness of the association between prolonged retinoid therapy and DISH. Thoracic pain, stiffness and entheseal symptoms in such patients warrant imaging and cessation of retinoids if DISH is found.

Item Type:	Article
Depositing User:	Symplectic Admin
Date Deposited:	01 Feb 2016 14:54
Last Modified:	31 Mar 2016 12:30
DOI:	10.1136/bcr-2015-209775
URI:	http://livrepository.liverpool.ac.uk/id/eprint/2049559

Repository Staff Access