isotretinoin and Cicatrix--Hypertrophic

Oral isotretinoin is the criterion standard treatment for severe inflammatory acne associated with scar development. Atypical or exaggerated cicatrization related to oral isotretinoin was reported throughout the 1980s and 1990s. Dermabrasion for atrophic acne scar revision is not recommended 6 to 12 months from the end of oral isotretinoin treatment.. To evaluate wound healing after localized dermabrasion in patients receiving oral isotretinoin.. Interventional, prospective study involving seven patients taking oral isotretinoin to treat acne and with atrophic acne scars on the face. Manual dermabrasion was performed on all patients in an area of approximately 1 cm(2), and a 6-month reepithelization follow-up by clinical evaluation was conducted.. All patients presented normal cicatrization evolution; hypertrophic scarring or keloid as a result of localized abrasion was not observed, and atrophic acne scar revision result was excellent.. The current recommendation to wait 6 to 12 months after treatment with oral isotretinoin for acne scar revision using dermabrasion should be re-evaluated. Abrasion of a small test area may be a useful predictor of wound healing, enabling earlier acne scar treatment using this procedure.

Topics: Acne Keloid; Acne Vulgaris; Administration, Oral; Adolescent; Adult; Cicatrix, Hypertrophic; Combined Modality Therapy; Dermabrasion; Dermatologic Agents; Face; Female; Humans; Isotretinoin; Male; Patient Satisfaction; Prospective Studies; Treatment Outcome; Wound Healing; Young Adult

Rhinophyma, a rare and progressive disfiguring condition, is thought to be the final stage of rosacea. Several surgical treatments are available, including dermabrasion, cryosurgery, scalpel excision, electrosurgery, and carbon dioxide laser. The last 2 techniques are the most effective for the management of rhinophyma. We describe a series of cases of moderate or severe rhinophyma treated with high-frequency electrosurgery in the dermatology department of Hospital Simón Bolivar and in private clinics in Bogota, Colombia, between 2012 and 2016. The cosmetic result, as assessed by both the clinicians and the patients, was satisfactory in all cases. Three patients presented hypertrophic scars that were treated with steroid injections and silicone gel sheeting. Two patients presented persistent erythema. However, there were no serious infections and none of the patients required further surgery. Electrosurgery is one of the simplest and most cost-effective techniques currently available for the treatment of rhinophyma by dermatologists.

Topics: Adrenal Cortex Hormones; Adult; Aged; Cicatrix, Hypertrophic; Combined Modality Therapy; Dermabrasion; Electrocoagulation; Electrosurgery; Esthetics; Female; Humans; Isotretinoin; Male; Middle Aged; Patient Satisfaction; Rhinophyma; Silicone Gels; Treatment Outcome

Acne vulgaris is a chronic inflammatory disease characterized by non-inflammatory and inflammatory lesions that can cause scarring. Oral isotretinoin is the current recommended treatment for moderate and severe cases; however, there are reports of possible influences on the healing process of the skin, leading to an increase in the risk for hypertrophic scars and keloids. This hypothesis, although unproven, represents a contraindication to the treatment of acne scars during the 6-12 months after the cessation of isotretinoin.. The aim of this study was to investigate the prevalences of hypertrophic scars and keloids in acne patients treated with oral isotretinoin.. Three data collection strategies were used: (i) clinical examination of patients with acne vulgaris, exposed or unexposed to oral isotretinoin, focusing on the occurrence of hypertrophic scars and/or keloids; (ii) telephone interviews of patients using oral isotretinoin to treat acne vulgaris on the occurrence or worsening of keloids; and (iii) clinical examination of patients with previous use of oral isotretinoin followed at a specific keloid treatment clinic.. The resulting data showed no differences in wound healing.. These findings may indicate that the occurrence of hypertrophic scars or keloids in patients using oral isotretinoin is an undesirable event arising from an individual response and may be related to inflammatory acne evolution.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Case-Control Studies; Cicatrix, Hypertrophic; Cross-Sectional Studies; Dermatologic Agents; Disease Progression; Female; Humans; Isotretinoin; Keloid; Male; Prevalence; Retrospective Studies; Wound Healing; Wounds and Injuries; Young Adult

The increased use of isotretinoin therapy for severe cystic acne has posed new problems for dermatologic surgeons. There have been recent reports in the literature of unexpected "atypical" scarring after dermabrasion in patients who have previously taken isotretinoin. This scarring was considered atypical because it occurred outside the typical "danger zones" (e.g., mandible and malar eminences) where scarring most often occurs after dermabrasion. This is the first reported case of atypical scarring in a patient who began isotretinoin therapy 2 months after dermabrasion.

Topics: Acne Vulgaris; Adult; Cicatrix, Hypertrophic; Combined Modality Therapy; Dermabrasion; Facial Dermatoses; Female; Humans; Isotretinoin