Atypical keloids after dermabrasion of patients taking isotretinoin

Should isotretinoin be stopped prior to surgery? A Critically Appraised Topic

“…An addendum to the article states that since completion of the study two additional patients developed unusual keloid scarring following dermabrasion to the face after recent isotretinoin treatment; no additional information is provided regarding these patients. Rubenstein et al 2 present a case series of six patients (three men and three women) undergoing dermabrasion for acne scarring, three while still taking isotretinoin and three who had stopped taking isotretinoin 2Á5-6 months previously. Skin type is mentioned for only two of the six patients: one was white and the other was Pakistani.…”

“…1,2 Prior to isotretinoin initiation, patients are often warned of the possible risk of abnormal scarring following such procedures, and this risk is also mentioned in the patient information leaflet for isotretinoin supplied by the manufacturers. 3 Whether the risk of abnormal scarring extends to other forms of elective or emergency surgery is less clear.…”

The rational use of systemic isotretinoin: A call for moderation

“…Initial worsening of acne; xerosis and cheilitis; retinoid dermatitis; epistaxis; staphylococcal infections of the skin, often of the nail folds, to cause paronychia; 13 pyogenic granulomas of the nail folds are often seen on the toes; 17 hypertrophic scarring and keloids -dermabrasion should be delayed after isotretinoin because severe hypertrophic scarring may result; 18,19 hypertrophic scarring has been reported when isotretinoin was administered 2 months after dermabrasion 20 and also spontaneously, without prior surgery, on isotretinoin therapy.…”

Update on the Management of Rosacea

“…Atypical keloid formation has also been documented following dermabrasion while on isotretinoin. 72,73 However, recent controlled investigations have analyzed skin healing in patients on oral isotretinoin therapy and have debunked previous concerns.…”