Causal Association between Isotretinoin and Inflammatory Bowel Disease: A Case Report

Abstract

Roaccutane® (isotretinoin) is used for the treatment of severe forms of acne resistant to adequate standard therapy. Inflammatory bowel disease (IBD) is described as a possible adverse drug reaction in the product information of isotretinoin. In a case study, we report the case of a 30 year old woman with a history of bloody diarrhea, abdominal pain and severe folliculitis/acne which had been treated with isotretinoin. Her clinical features worsened whilst on isotretinoin. Colonoscopy demonstrated diffuse ulcerative pancolitis. Isotretinoin treatment was discontinued and the patient was prescribed 5-aminosalicylic acid and corticosteroids. After a few months, steroids were discontinued and the patient went into clinical and laboratory remission. Evaluation of the possible causal association between isotretinoin treatment and IBD suggested a probable relationship, which should lead to considerable caution while prescribing this drug.