Hidradenitis suppurativa (HS) is a chronic, suppurative skin disease characterized by painful nodules, particularly in the axillae and groin. Isotretinoin can be used in the treatment of HS; however, it may paradoxically lead to skin lesions or worsen the existing lesions. Isotretinoin, which is commonly used in the treatment of severe acne, is associated with several side effects, including rheumatic side effects and rarely sacroiliitis. In this study, we discussed two cases who presented with low back pain after isotretinoin was used for the treatment of acne vulgaris. The patients did not have low back pain before isotretinoin use and did not have enthesitis, dactylitis, uveitis, psoriasis, recent infection, trauma, and family history spondylitis. HLA-B27 was negative. Bone-marrow edema was detected at the sacroiliac joint on magnetic resonance imaging. Because of these findings, sacroiliitis related to the drug was considered in our patients and isotretinoin treatments were discontinued. Because the patients' low back pain continued when they administered non-steroidal anti-inflammatory drugs, biological drug treatments were started. Both cases presented had a simultaneous HS lesion. After the treatment, both low back pain and HS lesions regressed. Patients with isotretinoin therapy should be alerted for inflammatory low back pain and HS lesions that may develop. We should note that biologic agents should be considered in the treatment of resistant cases.

中文翻译：

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异维A酸诱导的化脓性汗腺炎患者的sa关节炎：基于病例的审查。

化脓性Hidradenitis（HS）是一种慢性化脓性皮肤病，特征是结节特别是腋窝和腹股沟疼痛。异维A酸可用于治疗HS；但是，它可能自相矛盾地导致皮肤损害或使现有损害恶化。异维A酸通常用于治疗严重痤疮，它具有多种副作用，包括风湿性副作用和极少的sa关节炎。在这项研究中，我们讨论了两个在异维A酸治疗寻常型痤疮后出现腰痛的病例。患者在使用异维A酸之前没有下腰痛，也没有肠炎，触角炎，葡萄膜炎，牛皮癣，近期感染，外伤和家族史脊柱炎。HLA-B27为阴性。磁共振成像在the关节处检测到骨髓水肿。由于这些发现，我们的患者考虑了与药物相关的sa关节炎，并且异维A酸的治疗被中止。由于患者在服用非甾体类抗炎药时仍会腰痛，因此开始了生物药物治疗。所介绍的两个病例均具有同时的HS病变。治疗后，腰背痛和HS病变均消退。异维A酸治疗的患者应警惕炎症性下腰痛和可能发展的HS病变。我们应注意，在耐药病例的治疗中应考虑使用生物制剂。由于患者在服用非甾体类抗炎药时仍会腰痛，因此开始了生物药物治疗。所介绍的两个病例均具有同时的HS病变。治疗后，腰背痛和HS病变均消退。异维A酸治疗的患者应警惕炎症性下腰痛和可能发展的HS病变。我们应该注意，在耐药病例的治疗中应考虑使用生物制剂。由于患者在服用非甾体类抗炎药时仍会腰痛，因此开始了生物药物治疗。所介绍的两个病例均具有同时的HS病变。治疗后，腰背痛和HS病变均消退。异维A酸治疗的患者应警惕炎症性下腰痛和可能发展的HS病变。我们应注意，在耐药病例的治疗中应考虑使用生物制剂。