Refractory adhesive capsulitis under acitretin therapy.

Adhesive capsulitis (AC) is characterized by a limited active and passive motion. Although the exact pathology remains unknown, a number of contributing factors are discussed. AC has probably been caused by the Re-PUVA therapy (PUVA irradiation plus acitretin) of a cutaneous T-cell lymphoma, type mycosis fungoides. Acitretin belongs to the group of retinoids and is often used in cornification disorders. After non-successful initial conservative therapy with intraarticular steroid injections and physical therapy, a significant improvement of shoulder joint mobility was finally achieved by an arthroscopic juxtaglenoid capsulotomy and adhesiolysis. A therapy with acitretin should be considered as a possible trigger of AC. Patient's medication should be checked carefully on possible triggers of AC. The athroscopic adhesiolysis is an effective method for a frustrating conservative treatment of AC.