{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T11:42:47Z","timestamp":1788090167409,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>SAPHO syndrome is a rare autoinflammatory disorder characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis. Although musculoskeletal and dermatologic manifestations are well recognized, extra\u2010articular involvement remains uncommon, particularly muscular inflammation. We report the case of a 17\u2010year\u2010old male who presented with severe inflammatory low back pain and extensive nodulocystic acne for which he took escalating doses of isotretinoin. Clinical examination demonstrated positive sacroiliac stress tests, proximal muscle myopathy, and dermatologic evaluation confirmed acne conglobata. Laboratory testing revealed markedly elevated inflammatory markers. Magnetic resonance imaging of the sacroiliac joints showed bilateral asymmetric active sacroiliitis, fulfilling clinical criteria for Axial Spondyloarthritis. The infectious and autoimmune workup was negative. The patient responded favorably to isotretinoin withdrawal and immunosuppressive therapy, with sustained remission following steroid withdrawal. This case describes a rare and severe isotretinoin\u2010associated inflammatory myopathy in SAPHO syndrome, highlighting the need to expand the differential diagnosis of myopathy in SAPHO syndrome. It is imperative to exercise caution when prescribing isotretinoin to patients with SAPHO syndrome.<\/jats:p>","DOI":"10.1002\/ccr3.72970","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T08:55:29Z","timestamp":1781859329000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>SAPHO<\/scp>\n                    Syndrome Presenting With Severe Inflammatory Back Pain (Sacroiliitis) and Rare Retinol Associated Myopathy in an Iraqi Adolescent Male: A Case Report and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1577-6933","authenticated-orcid":false,"given":"Farah Jaafar","family":"Mahdi","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, College of Medicine University of Mustansiriyah  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Saad","family":"Al\u2010Shammari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine University of Baghdad  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Majid","family":"Hameed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine University of Baghdad  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwah Sami","family":"Ahmed","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Baghdad  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8995-1058","authenticated-orcid":false,"given":"Ibrahim","family":"Khalil","sequence":"additional","affiliation":[{"name":"Dhaka Medical College and Hospital  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahraa Saeed","family":"Fahad","sequence":"additional","affiliation":[{"name":"Dermatology Department Al\u2010Yarmouk Teaching Hospital  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Dahham","family":"Hasan","sequence":"additional","affiliation":[{"name":"Al\u2010Yarmouk Teaching Hospital  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0659-8130","authenticated-orcid":false,"given":"Nizar Abdulateef","family":"Jassim","sequence":"additional","affiliation":[{"name":"Iraqi Board for Medical Specializations, Department of Medicine, College of Medicine University of Baghdad  Baghdad 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