Indicators of Isotretinoin-Induced Myopathy: Neutrophil/Lymphocyte Ratio, Cobb Angle of Spine

Abstract

Objective: There are many side effects of isotretinoin on the musculoskeletal system, liver, nervous system and dermatological side effects. To investigate usage and side effects of isotretinoin (13-cis retinoic acid), which is popularly recommended by dermatologists for the treatment of acne vulgaris, on young patients admitted to the hospital with severe low back and neck pains.Methods: We evaluated 61 patients who, using isotretinoin for the treatment of acne vulgaris for an average of eight months, experienced cervical and lumbar pain between 2017-2019. The age range of patients was between 16 and 38 years, there were 45 female and 16 male patients. These patients used isotretinoin at a dose of 0.5-0.8 mg/kg/day for the treatment of acne vulgaris for about eight months. The patients were questioned about cervical and lower back pain, joint pain, muscle weakness, myoglobinuria, creatine phospo-kinase (CPK), Visual Analog Scale (VAS), inflammation myopathy, neutrophil/lymphocyte ratio (Neu/Lymp ratio), and Cobb angle of the spine during monthly controls.Results: The VAS and Neu/Lymp ratio, cervical and lumbar Cobb angles of the patients were statistically analyzed and the relationship between them was shown.Conclusion: The Neu/Lymp ratio and Cobb angle of the cervical and lumbar spine should be considered as an alternative or additional parameter to diagnose drug-induced myopathy.