Raneses Eli, Schmidgal Eric C
General Medicine, Naval Hospital Camp Pendleton, Oceanside, USA.
Department of Dermatology, Naval Medical Center San Diego, San Diego, USA.
Cureus. 2022 Jun 15;14(6):e25981. doi: 10.7759/cureus.25981. eCollection 2022 Jun.
Acne vulgaris is one of the most common skin conditions treated by healthcare providers. Isotretinoin is a well-known and effective treatment for nodulocystic and scarring acne. Rarely, and usually in combination with exercise, patients treated with isotretinoin can develop rhabdomyolysis, a potentially life-threatening breakdown of muscle associated with elevated creatine kinase (CK). Here, we report a rare case of a female patient developing rhabdomyolysis three months after starting exercise and isotretinoin. She was treated with supportive care and medication was discontinued, resulting in a full recovery. Careful inquiry into the patient's exercise habits, along with a thorough review of systems at each visit can help identify high-risk patients. Routine monitoring of liver enzymes, specifically aspartate aminotransferase elevations, may provide a prompt to check a patient's CK. Though regular monitoring of CK is not currently recommended, given the prevalence of regular exercise in certain patient populations, this case reinforces the importance of counseling patients on this potential side effect.
寻常痤疮是医疗服务提供者治疗的最常见皮肤疾病之一。异维A酸是治疗结节囊肿性和瘢痕性痤疮的一种知名且有效的药物。接受异维A酸治疗的患者很少会发生横纹肌溶解,通常是在与运动相结合的情况下发生,这是一种与肌酸激酶(CK)升高相关的潜在危及生命的肌肉分解。在此,我们报告一例罕见病例,一名女性患者在开始运动和服用异维A酸三个月后发生横纹肌溶解。她接受了支持性治疗,药物停用,最终完全康复。仔细询问患者的运动习惯,并在每次就诊时全面检查身体各系统,有助于识别高危患者。常规监测肝酶,特别是天冬氨酸转氨酶升高情况,可能提示检查患者的CK。虽然目前不建议定期监测CK,但鉴于某些患者群体经常运动的普遍性,该病例强化了就这种潜在副作用向患者提供咨询的重要性。