Accutane & Autoimmunity: The Link To Sjogren’s Syndrome

Introduction

Sjogrens syndrome is an autoimmune condition that has a striking overlap to the many side effects of Accutane treatment. The condition is characterised by the destruction of the exocrine glands, such as the sebaceous glands, tear ducts and saliva. One of the primary characteristics of this condition is excessively dry skin, which is why parallels are often drawn with the effects of Accutane treatment. Other symptoms include dry eyes, fatigue, and muscle and joint pain – which are notably also complaints of Accutane treatment.

The ‘dryness’ of Sjorgens syndrome also extends to other mucosal tissues such as airways, digestive tracts, and reproductive organs. The link to Vitamin A was even recognised as far back as 1933 by the Danish ophthalmologist Sjorgen after whom the condition is named. He made his name by differentiating the dry eyes induced by Vitamin A deficiency (known as xerophalmia) from the Keratoconjunctivitis (dry inflamed cornea) manifested in Sjogrens syndrome. Since then, the diagnosis of Sjogrens Syndrome has expanded to also include connective tissue disease, such as arthritis, as secondary Sjogrens Syndrome. [1]

The association with Connective Tissue presents another interesting overlap with Isotretinoin, as treatment with the acne drug is recognised to induce arthralgia (joint pain) in around half of patients. [2] There’s even been case reports of Isotretinoin causing arthritic symptoms that mimic rheumatoid arthritis. [3]