Surgical excision of the pigmented nail matrix followed by histopathologic examination is a common procedure aimed at managing longitudinal melanonychia (LM). In some cases, use of a standard scalpel can pose challenges, particularly if the width of the pigmented matrix lesion is narrow. We explore an alternative and effective tool-the customized dermal curette.
Isotretinoin is widely used for treatment of severe cystic acne; however, its use is accompanied by mucocutaneous adverse effects. The established protocol for conducting cutaneous procedures on patients undergoing current or recent treatment with isotretinoin recommends a cessation period of at least 6 months to mitigate risks for delayed wound healing and hypertrophic scarring due to medication-induced skin fragility. We present a unique case of isotretinoin-induced skin fragility resulting in blistering and erosions on the palms of a 25-year-old competitive aerial trapeze artist. This case highlights the underrecognized risk for skin vulnerability in athletes undergoing isotretinoin treatment and the importance of guiding athletes on heightened skin vulnerability during isotretinoin treatment.
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