Spondyloarthritic Changes During Acitretin Treatment

Abstract

Keratosis follicularis, also called as Darier disease, is a rare disease characterized bykeratotic papules in sebum-rich skin areas. Oral or topical retinoids, topical or systemic glucocorticoidsfrequently utilised in the treatment of keratosis follicularis. Aberrant musculoskeletalsigns are not normally expected in keratosis follicularis, however, they may rarely arise fromoral retinoids like acitretin. In this case, inflammatory type back pain, morning stifness and limitationof spinal mobility were developed after acitretin therapy. The patient's blood tests revealedacute inflammation and sacroiliac MRI showed right-sided sacroiliitis in the patient. Thepathophysiological mechanisms of such complications related to the use of systemic retinoids arecurrently unclear. We report the development unilateral sacroiliitis after the use of acitretin ina 57-year-old woman with keratosis follicularis who previously not diagnosed as spondyloarthritis.