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Surgical outcome in patients taking concomitant or recent intake of oral isotretinoin: A multicentric Study-ISO-AIMS study
Omprakash Heggadahalli Mahadevappa1, Venkataram Mysore2, Vishalakshi Viswanath3, Salim Thurakkal3, Imran Majid4, Suresh Talwar5, Sanjeev J Aurangabadkar6, Manas Chatterjee7, Ramesh M Bhat8, Shyamanta Barua9, Anil Ganjoo10
1 Department of Dermatology, Vikram Perfect, Mysuru, India
2 Centre for Advanced Dermatology and Post Graduate Training, Bengaluru, Karnataka, India
3 Disha Skin and Laser Institute, Thane, Maharashtra, India
4 Cutis Skin and Laser Institute, Srinagar, Jammu and Kashmir, India
5 Talwar Skin Centre, Lucknow, Uttar Pradesh, India
6 Department of Dermatology and Laser Surgery, Skin and Laser Clinic, Hyderabad, Telangana, India
7 Department of Dermatology, INHS Asvini, Colaba, Mumbai, India
8 Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka, India
9 Department of Dermatology, Assam Medical College and Hospital, Dibrugarh, Assam, India
10 Skinnovation Laser Clinic, New Delhi, India
Correspondence Address:
Omprakash Heggadahalli Mahadevappa
Department of Dermatology, Vikram Perfect, #94, K.R.S. Road, Gokulam, Mysuru - 570 002, Karnataka
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-2077.184054
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Background: The current standard recommendation is to avoid surgical interventions in patients taking oral isotretinoin. However, this recommendation has been questioned in several recent publications. Aim: To document the safety of cosmetic and surgical interventions, among patients receiving or recently received oral isotretinoin. Materials and Methods: Association of Cutaneous Surgeons, India, in May 2012, initiated this study, at 11 centers in different parts of India. The data of 183 cases were collected monthly, from June 2012 to May 2013. Of these 61 patients had stopped oral isotretinoin before surgery and 122 were concomitantly taking oral isotretinoin during the study period. In these 183 patients, a total of 504 interventions were performed. These included[1] 246 sessions of chemical peels such as glycolic acid, salicylic acid, trichloroacetic acid, and combination peels;[2] 158 sessions of lasers such as ablative fractional laser resurfacing with erbium-doped yttrium aluminum garnet and CO2, conventional full face CO2laser resurfacing, laser-assisted hair reduction with long-pulsed neodymium-doped yttrium aluminum garnet, diode laser, and LASIK surgery;[3] 27 sessions of cold steel surgeries such as microneedling, skin biopsy, subcision, punch elevation of scars, excision of skin lesion, and wisdom tooth extraction;[4] 1 session of electrosurgery. Results: No significant side effects were noted in most patients. 2 cases of keloid were documented which amounted to 0.4% of side effects in 504 interventions, with a significant P value of 0.000. Reversible transient side effects were erythema in 10 interventions and hyperpigmentation in 15. Conclusion: The study showed that performing dermatosurgical and laser procedures in patients receiving or recently received isotretinoin is safe, and the current guidelines of avoiding dermatosurgical and laser interventions in such patients taking isotretinoin need to be revised. |
