Case report
Isotretinoin-induced arthritis: A rare but feasible diagnosis. Case report
Artritis inducida por isotretinoína: un diagnóstico infrecuente pero factible. Reporte de caso
Read
4708
Timeswas read the article
131
Total PDF
4577
Total HTML
Share statistics
array:24 [ "pii" => "S2444440522000383" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2020.09.006" "estado" => "S300" "fechaPublicacion" => "2022-10-01" "aid" => "1819" "copyright" => "Asociación Colombiana de Reumatología" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Colomb Reumatol. 2022;29:417-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0121812320301420" "issn" => "01218123" "doi" => "10.1016/j.rcreu.2020.09.003" "estado" => "S300" "fechaPublicacion" => "2022-10-01" "aid" => "1819" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Colomb Reumatol. 2022;29:417-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Informe de caso</span>" "titulo" => "Artritis inducida por isotretinoína: un diagnóstico infrecuente pero factible. Reporte de caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "417" "paginaFinal" => "419" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Isotretinoin-induced arthritis: A rare but feasible diagnosis. Case report" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Michelle Daniela Parada-Artunduaga, Juan Sebastián Segura-Charry" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Michelle Daniela" "apellidos" => "Parada-Artunduaga" ] 1 => array:2 [ "nombre" => "Juan Sebastián" "apellidos" => "Segura-Charry" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2444440522000383" "doi" => "10.1016/j.rcreue.2020.09.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440522000383?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812320301420?idApp=UINPBA00004N" "url" => "/01218123/0000002900000004/v1_202210190543/S0121812320301420/v1_202210190543/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S244444052200053X" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2021.02.007" "estado" => "S300" "fechaPublicacion" => "2022-10-01" "aid" => "18440" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Colomb Reumatol. 2022;29:420-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Gonococcal arthritis in a healthy adult. Is it that possible?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "420" "paginaFinal" => "422" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Artritis gonocócica en un adulto sano. ¿Es posible?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1589 "Ancho" => 1259 "Tamanyo" => 121592 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Chocolate blood agar growth medium showed the overgrowth of <span class="elsevierStyleItalic">N. gonorrhoeae</span>.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Alejandra Valero, Fabien Mantilla, Rubén Darío Mantilla, Juan Sebastián Bravo-Ojeda, Juan Manuel Anaya" "autores" => array:5 [ 0 => array:2 [ "nombre" => "María Alejandra" "apellidos" => "Valero" ] 1 => array:2 [ "nombre" => "Fabien" "apellidos" => "Mantilla" ] 2 => array:2 [ "nombre" => "Rubén Darío" "apellidos" => "Mantilla" ] 3 => array:2 [ "nombre" => "Juan Sebastián" "apellidos" => "Bravo-Ojeda" ] 4 => array:2 [ "nombre" => "Juan Manuel" "apellidos" => "Anaya" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S244444052200053X?idApp=UINPBA00004N" "url" => "/24444405/0000002900000004/v1_202302231847/S244444052200053X/v1_202302231847/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2444440522000590" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2021.03.006" "estado" => "S300" "fechaPublicacion" => "2022-10-01" "aid" => "1913" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Colomb Reumatol. 2022;29:409-16" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Intravenous infusion of mesenchymal stem cells for refractory systemic sclerosis management: Two-year follow-up" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "409" "paginaFinal" => "416" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infusión intravenosa de células madre mesenquimales para el manejo de la esclerosis sistémica refractaria: reporte de caso con seguimiento a 2 años" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2909 "Ancho" => 2516 "Tamanyo" => 465655 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Changed in the Incisor-incisor mouth opening two years after infusion and change in sclerosis and telangiectasis in face. A: Before treatment; B: two years infusion.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rossana Mejia, Benjamin Ospino, Luis Castro, Jenniffer P. Avila, Viviana Reyes-Martinez, John Londono, Mabel Avila-Portillo" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Rossana" "apellidos" => "Mejia" ] 1 => array:2 [ "nombre" => "Benjamin" "apellidos" => "Ospino" ] 2 => array:2 [ "nombre" => "Luis" "apellidos" => "Castro" ] 3 => array:2 [ "nombre" => "Jenniffer P." "apellidos" => "Avila" ] 4 => array:2 [ "nombre" => "Viviana" "apellidos" => "Reyes-Martinez" ] 5 => array:2 [ "nombre" => "John" "apellidos" => "Londono" ] 6 => array:2 [ "nombre" => "Mabel" "apellidos" => "Avila-Portillo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440522000590?idApp=UINPBA00004N" "url" => "/24444405/0000002900000004/v1_202302231847/S2444440522000590/v1_202302231847/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Isotretinoin-induced arthritis: A rare but feasible diagnosis. Case report" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "417" "paginaFinal" => "419" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Michelle Daniela Parada-Artunduaga, Juan Sebastián Segura-Charry" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Michelle Daniela" "apellidos" => "Parada-Artunduaga" "email" => array:1 [ 0 => "michelleparada65@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Juan Sebastián" "apellidos" => "Segura-Charry" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital de La Samaritana, Zipaquirá, Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Rheumatology Service, Clínica Medilaser, Neiva, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Artritis inducida por isotretinoína: un diagnóstico infrecuente pero factible. Reporte de caso" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">When we face the scenario of a patient who presents a symptomatic articular clinical picture of inflammatory nature, we have in mind certain baseline conditions that predispose to its development, such as genetic susceptibility, which occurs in 50–70% of cases.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However, most of the time it requires an external trigger (epigenetic) that conditions the loss of immunological tolerance such as environmental situations,<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> smoking,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> obesity<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> or infections,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> as well as the exposure to certain substances such as the drugs<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> which have been described as causes of inflammatory and autoimmune exacerbations. Among these substances, the use of retinoids has been reported as a causal factor, usually associated with the development of musculoskeletal symptoms<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> and symptoms suggestive of spondyloarthritis, predominantly with sacroiliitis.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10–12</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">There are few descriptions of cases with development of peripheral arthritis associated with the use of isotretinoin.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13–16</span></a> Therefore, the interest of our report lies in describing the onset of peripheral inflammatory symptoms with the use of isotretinoin in a previously healthy patient.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 43-year-old female patient with a history of acne conglobata at the age of 18 years, managed with topical treatment for approximately 18 months, with complete improvement of her underlying disease (at that time). The patient has a family history of rheumatoid arthritis in first maternal line. Previously, she was in a healthy joint and musculoskeletal condition. Due to reappearance of acne conglobata on the cheeks and chin, dermatology started management with isotretinoin 40 mg/day. Approximately 2 months after starting treatment, she began to present arthralgia in the right shoulder, exacerbated by exposure to cold. In her first assessment, she had a right lateral epicondylitis, without synovitis, and it was decided to start management with calcitriol 0.25 µg/day and hydrolyzed collagen 10 g/day. However, the condition evolved with painful symptomatic addition to the elbows, right knee and heels, with a tendinopathic nature that worsened at rest, without clinical synovitis, but with evident morning stiffness lasting a few minutes, while she continued taking the isotretinoin.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The paraclinical studies are: ESR 69 mm/h (0–20), CRP 14.6 mg/l (0–6). Otherwise, the entire immune profile was negative. Bearing in mind the symptomatic change, now with more noticeable inflammatory manifestations, a possible undifferentiated arthritis facilitated by the use of retinoid was considered. It was decided to add hydroxychloroquine 200 mg/day, and it was agreed with dermatology to discontinue treatment with isotretinoin.</p><p id="par0025" class="elsevierStylePara elsevierViewall">2 months later, the patient refers improvement in the symptoms after suspending the isotretinoin, she never took the hydroxychloroquine, and brought a new set of paraclinical tests, with normalization of acute phase reactants (ESR 17 mm/h [0–20], CRP 5.5 mg/l [0–6]), therefore, it is considered an isotretinoin-induced arthritis, with an intermediate probability according to the Naranjo scale (6 points)<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> and spontaneous resolution, in a patient with a history of risk due to a maternal history of rheumatoid arthritis. Currently, the patient remains asymptomatic after 2 years of discontinuation of the retinoid treatment.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Isotretinoin is the most widely used retinoid for severe acne due to its high efficacy. However, multiple side effects derived from its consumption have been described, among which is the appearance of musculoskeletal manifestations that can often occur even with low doses of the medication.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16,18,19</span></a> Cytopathic destruction of the synovial membrane has been suggested as a hypothesis of causality due to its detergent action.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16,18</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Musculoskeletal effects are common with the use of isotretinoin, having been reported in approximately 25% of patients.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,18</span></a> At this point, very few cases of acute aseptic arthritis due to the use of retinoids have been described in the literature, beginning between 2–10 weeks after the start of the retinoid, usually in a monoarticular pattern with predominance in knees or ankles (some cases of polyarticular appearance with involvement of elbows, hips or toes), with joint effusion, and the study of the synovial fluid with findings of non-inflammatory type. In general, these symptoms resolve with non-steroidal anti-inflammatory drugs (NSAIDs), but above all the greatest impact is obtained by discontinuing the retinoid treatment. It is necessary to take into account that isotretinoin generates great benefits in patients with dermatoses, so many people prefer to endure pain or musculoskeletal limitations, as long as this avoids a recurrence of their skin condition.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,20</span></a></p></span><span id="sec1020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1040">Ethical Considerations</span><p id="par1040" class="elsevierStylePara elsevierViewall">The consent of the patient for the publication of the case was previously requested and it was approved by the ethics committee of the Medilaser clinic.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1853473" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1611292" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1853472" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1611291" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec1020" "titulo" => "Ethical Considerations" ] 8 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-06-22" "fechaAceptado" => "2020-09-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1611292" "palabras" => array:3 [ 0 => "Arthritis" 1 => "Isotretinoin" 2 => "Abnormalities, drug induced" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1611291" "palabras" => array:3 [ 0 => "Artritis experimental" 1 => "Isotretinoína" 2 => "Artritis inducida por medicamentos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Many medications and vaccines have had implications in the development of musculoskeletal and joint symptoms, and among them the use of retinoids has been associated with the development of musculoskeletal symptoms, as well as axial symptoms suggestive of spondyloarthritis, with sacroiliitis, and to a lesser extent the development of peripheral symptoms. We describe the debut of peripheral inflammatory symptoms with the use of isotretinoin, in a previously healthy patient.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Muchos medicamentos y vacunas han tenido implicaciones en el desarrollo de síntomas osteomusculares y articulares. Entre ellos, el uso de retinoides se ha asociado con el desarrollo de síntomas musculoesqueléticos, así como síntomas axiales sugestivos de espondiloartritis, con sacroiliitis, y en menor proporción el desarrollo de síntomas periféricos. Describimos el debut de síntomas inflamatorios periféricos con el uso de isotretinoína, en una paciente previamente sana.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A review of the MHC genetics of rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.L. Newton" 1 => "S.M.J. Harney" 2 => "B.P. Wordsworth" 3 => "M.A. Brownl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.gene.6364045" "Revista" => array:6 [ "tituloSerie" => "Genes Immun" "fecha" => "2004" "volumen" => "5" "paginaInicial" => "151" "paginaFinal" => "157" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14749714" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early environmental factors and rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.J. Edwards" 1 => "C. Cooper" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2249.2005.02940.x" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Immunol" "fecha" => "2006" "volumen" => "143" "paginaInicial" => "1" "paginaFinal" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16367927" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Environmental influences on risk for rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.P. Liao" 1 => "L. Alfredsson" 2 => "E.W. Karlson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/BOR.0b013e32832a2e16" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Rheumatol" "fecha" => "2009" "volumen" => "21" "paginaInicial" => "279" "paginaFinal" => "283" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19318947" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking and rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Chang" 1 => "S.M. Yang" 2 => "S.H. Kim" 3 => "K.H. Han" 4 => "S.J. Park" 5 => "J.L. Shin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/ijms151222279" "Revista" => array:6 [ "tituloSerie" => "Int J Mol Sci" "fecha" => "2014" "volumen" => "15" "paginaInicial" => "22279" "paginaFinal" => "22295" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25479074" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The obesity epidemic and consequences for rheumatoid arthritis care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.D. George" 1 => "J.F. Baker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11926-015-0550-z" "Revista" => array:5 [ "tituloSerie" => "Curr Rheumatol Rep" "fecha" => "2016" "volumen" => "18" "paginaInicial" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26739963" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microbial infection and rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Li" 1 => "Y. Yu" 2 => "Y. Yue" 3 => "Z. Zhang" 4 => "K. Su" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4172/2155-9899.1000174" "Revista" => array:5 [ "tituloSerie" => "J Clin Cell Immunol" "fecha" => "2013" "volumen" => "4" "paginaInicial" => "174" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25133066" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An update on drug-induced arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.H. Adwan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00296-016-3462-y" "Revista" => array:6 [ "tituloSerie" => "Rheumatol Int" "fecha" => "2016" "volumen" => "36" "paginaInicial" => "1089" "paginaFinal" => "1097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27000044" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isotretinoin use in acne: prospective evaluation of adverse events" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.R. Hull" 1 => "C. Demkiw-Bartel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/120347540000400205" "Revista" => array:6 [ "tituloSerie" => "J Cutan Med Surg" "fecha" => "2000" "volumen" => "4" "paginaInicial" => "66" "paginaFinal" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11179927" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rheumatological symptoms due to retinoids" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Kaplan" 1 => "B. Haettich" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0950-3579(05)80297-3" "Revista" => array:6 [ "tituloSerie" => "Baillieres Clin Rheumatol" "fecha" => "1991" "volumen" => "5" "paginaInicial" => "77" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2070429" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isotretinoin-induced spondyloarthropathy-related symptoms: A prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Alkan" 1 => "N. Kayiran" 2 => "O. Zengin" 3 => "A. Kalem" 4 => "G. Kimyon" 5 => "E.O. Kilinc" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3899/jrheum.150013" "Revista" => array:6 [ "tituloSerie" => "J Rheumatol" "fecha" => "2015" "volumen" => "42" "paginaInicial" => "2106" "paginaFinal" => "2109" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26472411" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sacroiliitis during isotretinoin treatment: Causal association or coincidence?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Aydog" 1 => "G. Ozturk" 2 => "A. Comert" 3 => "N. Tasdelen" 4 => "O. Akin" 5 => "D.G. Kulcu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.14744/nci.2018.93798" "Revista" => array:6 [ "tituloSerie" => "North Clin Istanb" "fecha" => "2019" "volumen" => "6" "paginaInicial" => "75" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31180372" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isotretinoin-induced arthritis mimicking both rheumatoid arthritis and axial spondyloarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "O. Yilmaz Tasdelen" 1 => "F.G. Yurdakul" 2 => "S. Duran" 3 => "H. Bodur" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1756-185X.12464" "Revista" => array:6 [ "tituloSerie" => "Int J Rheum Dis" "fecha" => "2015" "volumen" => "18" "paginaInicial" => "466" "paginaFinal" => "469" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25294249" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[Acute arthritis during isotretinoin treatment]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Callot" 1 => "S. Ochonisky" 2 => "P. Vabres" 3 => "J. Revuz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "1994" "volumen" => "121" "paginaInicial" => "402" "paginaFinal" => "403" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7702267" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute arthritis during isotretinoin therapy for acne" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Camisa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0190-9622(86)80320-6" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1986" "volumen" => "15" "paginaInicial" => "1061" "paginaFinal" => "1062" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3782529" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arthritis precipitated by isotretinoin treatment for acne vulgaris" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.A. Hughes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Rheumatol" "fecha" => "1993" "volumen" => "20" "paginaInicial" => "1241" "paginaFinal" => "1242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8371229" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute arthritis during isotretinoin treatment for acne" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.Y. Matsuoka" 1 => "J. Wortsman" 2 => "J.J. Pepper" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "1984" "volumen" => "144" "paginaInicial" => "1870" "paginaFinal" => "1871" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6236765" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A method for estimating the probability of adverse drug reactions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:1 [ 0 => "C.A. Naranjo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/clpt.1981.154" "Revista" => array:6 [ "tituloSerie" => "Clin Pharmacol Ther" "fecha" => "1981" "volumen" => "30" "paginaInicial" => "239" "paginaFinal" => "245" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7249508" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute arthritis during isotretinoin treatment for acne conglobata" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. De Francesco" 1 => "G. Stinco" 2 => "M. Campanella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000246098" "Revista" => array:5 [ "tituloSerie" => "Dermatology" "fecha" => "1997" "volumen" => "194" "paginaInicial" => "195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9094478" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Musculoskeletal syndromes associated with acne" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.H. Knitzer" 1 => "B.W. Needleman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0049-0172(91)90020-z" "Revista" => array:6 [ "tituloSerie" => "Semin Arthritis Rheum" "fecha" => "1991" "volumen" => "20" "paginaInicial" => "247" "paginaFinal" => "255" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1828308" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rising erythrocyte sedimentation rate in a patient with treated polymyalgia rheumatica: Colon cancer as an accidental association versus paraneoplastic syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Awadh" 1 => "N.I. Abdou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.rhu.0000208811.06967.c8" "Revista" => array:5 [ "tituloSerie" => "J Clin Rheumatol" "fecha" => "2006" "volumen" => "12" "paginaInicial" => "102" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16601549" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24444405/0000002900000004/v1_202302231847/S2444440522000383/v1_202302231847/en/main.assets" "Apartado" => array:4 [ "identificador" => "53647" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24444405/0000002900000004/v1_202302231847/S2444440522000383/v1_202302231847/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440522000383?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 44 | 2 | 46 |
| 2024 October | 374 | 5 | 379 |
| 2024 September | 379 | 7 | 386 |
| 2024 August | 267 | 6 | 273 |
| 2024 July | 290 | 6 | 296 |
| 2024 June | 205 | 6 | 211 |
| 2024 May | 249 | 11 | 260 |
| 2024 April | 326 | 15 | 341 |
| 2024 March | 350 | 5 | 355 |
| 2024 February | 275 | 2 | 277 |
| 2024 January | 382 | 6 | 388 |
| 2023 December | 269 | 5 | 274 |
| 2023 November | 313 | 8 | 321 |
| 2023 October | 321 | 9 | 330 |
| 2023 September | 229 | 4 | 233 |
| 2023 August | 198 | 3 | 201 |
| 2023 July | 104 | 2 | 106 |
| 2023 March | 2 | 0 | 2 |
| 2023 February | 0 | 11 | 11 |
| 2023 January | 0 | 7 | 7 |
| 2022 December | 0 | 6 | 6 |
| 2022 November | 0 | 5 | 5 |
Show all
