The laboratory tests that should be performed and their frequency during isotretinoin treatment are controversial. We wanted to investigate muscle and joint pain and laboratory tests in acne patients who received isotretinoin. Between April 2019 and February 2023, serum CK, AST, ALT, and GGT levels were retrospectively evaluated in acne patients before and three months after systemic isotretinoin treatment. This study included 410 patients. The median serum AST, ALT, and GGT levels significantly increased, whereas serum CK levels were similar in all patients three months after treatment. 23 (5.6%) patients revealed muscle or joint pain after treatment. No significant difference was detected in patients with or without pain in the median serum CK, AST, ALT, and GGT levels after treatment. Isotretinoin treatment at a dose of 10 mg/day was more common in patients with pain than in those without pain, whereas none of the patients who received isotretinoin 40 mg/day developed muscle or joint pain. We suggest that routine evaluation of serum CK levels is unnecessary in acne patients treated with isotretinoin. However, muscle and joint pain may develop even at doses as low as 10 mg/day. Furthermore, monitoring AST, ALT, and GGT levels may be beneficial in acne patients treated with isotretinoin.
Psoriasis has been associated with metabolic syndrome and nonalcoholic fatty liver disease. We wanted to investigate the abdominal ultrasonography results of psoriasis patients before biological agent treatment. Between April 2019 and February 2022, abdominal ultrasonography results of psoriasis patients which were performed before biological agent treatment were reviewed retrospectively. This study included 90 patients, 45 females, and 45 males with a mean age of 48.91±13.43 years. The most common ultrasonography finding was increased echogenicity of the liver parenchyma due to steatosis (58.9%) which was followed by an increase in liver size (25.6%), kidney cysts (17.8%), gallstones (8.9%) and increase in spleen size (7.8%). Hepatic steatosis was more frequent in older patients (p<0.001), patients with diabetes (p=0.007), and patients who were previously treated with biological agents (p=0.007). 70.4% of the patients with moderate or severe hepatic steatosis were female. Herein, hepatic steatosis was detected in 53 (58.9%) patients. Nonalcoholic fatty liver disease which presents as hepatic steatosis in early stages has an asymptomatic course and poor prognosis in psoriasis patients. We suggest that abdominal ultrasonography should be performed in psoriasis patients before biological agent treatment, especially in females, patients with advanced age, patients who were previously treated with biological agents, and patients with diabetes.
