title: Surgical Outcome in Patients Taking Concomitant or Recent Intake of Oral Isotretinoin: A Multicentric Study-ISO-AIMS Study.
abstract: 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.
  
  
  OBJECTIVE
  To document the safety of cosmetic and surgical interventions, among patients receiving or recently received oral isotretinoin.
  
  
  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 CO2 laser 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatology, Vikram Perfect, Mysuru, India.
authors.forename: Omprakash Heggadahalli
authors.initials: OH
authors.lastname: Mahadevappa
authors.affiliation: Centre for Advanced Dermatology and Post Graduate Training, Bengaluru, Karnataka, India.
authors.forename: Venkataram
authors.initials: V
authors.lastname: Mysore
authors.affiliation: Disha Skin and Laser Institute, Thane, Maharashtra, India.
authors.forename: Vishalakshi
authors.initials: V
authors.lastname: Viswanath
authors.affiliation: Cutis Institute, Calicut, Kerala, India.
authors.forename: Salim
authors.initials: S
authors.lastname: Thurakkal
authors.affiliation: Cutis Skin and Laser Institute, Srinagar, Jammu and Kashmir, India.
authors.forename: Imran
authors.initials: I
authors.lastname: Majid
authors.affiliation: Talwar Skin Centre, Lucknow, Uttar Pradesh, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Talwar
authors.affiliation: Department of Dermatology and Laser Surgery, Skin and Laser Clinic, Hyderabad, Telangana, India.
authors.forename: Sanjeev J
authors.initials: SJ
authors.lastname: Aurangabadkar
authors.affiliation: Department of Dermatology, INHS Asvini, Colaba, Mumbai, India.
authors.forename: Manas
authors.initials: M
authors.lastname: Chatterjee
authors.affiliation: Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka, India.
authors.forename: M Ramesh
authors.initials: MR
authors.lastname: Bhat
authors.affiliation: Department of Dermatology, Assam Medical College and Hospital, Dibrugarh, Assam, India.
authors.forename: Shyamanta
authors.initials: S
authors.lastname: Barua
authors.affiliation: Skinnovation Laser Clinic, New Delhi, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Ganjoo
keywords: Guidelines; hypertrophic scar; isotretinoin; keloid; side effects