Department of Dermatology, Hospital São Paulo, Brazil.
Dermatol Surg. 2010 Apr;36(4):483-9. doi: 10.1111/j.1524-4725.2010.01474.x. Epub 2010 Feb 17.
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.
MATERIALS & METHODS: 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.
口服异维 A 酸是治疗伴有瘢痕形成的严重炎症性痤疮的标准治疗方法。在整个 20 世纪 80 年代和 90 年代，都有报道称口服异维 A 酸会导致非典型或过度的瘢痕形成。不建议在口服异维 A 酸治疗结束后 6 至 12 个月内进行磨皮术来修复萎缩性痤疮瘢痕。
评估口服异维 A 酸治疗的患者接受局部磨皮术后的伤口愈合情况。
这是一项干预性、前瞻性研究，共纳入 7 名接受口服异维 A 酸治疗痤疮且面部有萎缩性痤疮瘢痕的患者。所有患者均接受了约 1cm²的手动磨皮术，通过临床评估进行为期 6 个月的再上皮化随访。
所有患者的瘢痕均正常愈合；未观察到因局部磨损导致的增生性瘢痕或瘢痕疙瘩，且萎缩性痤疮瘢痕修复效果极佳。
目前建议在使用磨皮术治疗痤疮瘢痕前等待口服异维 A 酸治疗痤疮后 6 至 12 个月，但这种建议可能需要重新评估。磨皮术小面积测试可能是伤口愈合的有用预测指标，从而可以更早地使用该程序治疗痤疮瘢痕。
