Severe hyperpigmentation and scarring following glycolic acid peel treatment in combination with low-dose isotretinoin.
BACKGROUND
The application of systemic isotretinoin in the treatment of cutaneous photoaging has been well investigated. In addition, well-recognized topical antiaging therapies such as superficial chemical peeling (CP) with α-hydroxy acids have been shown to be more helpful when combined with low-dose oral isotretinoin. Even though the combination of systemic isotretinoin and medium to deep CP has been associated with serious side effects such as delayed wound healing and enlarged incidence of scarring, to date superficial CP and concomitant systemic isotretinoin have been considered safe.


METHODS
In this report, we present the case of a patient receiving low-dose oral isotretinoin therapy who developed severe painful erythema and erosions that led to permanent hyperpigmentation and scarring of her face and neck after undergoing superficial CP with glycolic acid.


CONCLUSIONS
There is a potential risk of hyperpigmentation and scarring with the use of a combination of low-dose oral isotretinoin and glycolic acid peeling.
Department of Dermatology, Medical Faculty, Heinrich Heine University Dusseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany. peterarne.gerber@med.uni-duesseldorf.de.
Peter Arne
PA
Gerber
Department of Dermatology, Medical Faculty, Heinrich Heine University Dusseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany. gabrielakukova@med.uni-duesseldorf.de.
Gabriela
G
Kukova
Department of Radiation Oncology, Medical Faculty, Heinrich Heine University Dusseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany. boelke@med.uni-duesseldorf.de.
Edwin
E
Bölke
Department of Dermatology, Medical Faculty, Heinrich Heine University Dusseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany. homey@uni-duesseldorf.de.
Bernhard
B
Homey
Department of Dermatology, Medical Faculty, Heinrich Heine University Dusseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany. Diedrichson@med.uni-duesseldorf.de.
Evelyn
E
Diedrichson
D000284:Administration, Oral; D000328:Adult; D002921:Cicatrix / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006016:Glycolates / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D017495:Hyperpigmentation / Q000175:diagnosis / Q000188:drug therapy*; D015474:Isotretinoin / Q000008:administration & dosage / Q000627:therapeutic use*
D006016:Glycolates; C031149:glycolic acid; D015474:Isotretinoin