Effect of acitretin on wound healing in organ transplant recipients

Systemic retinoids possess significant benefits in cutaneous malignancy chemoprevention; however, retinoids have been associated with excessive granulation tissue and hypertrophic scarring.

The objective of this study was to assess wound healing outcomes in organ transplant recipients, both with and without the concomitant use of systemic acitretin chemoprophylaxis.

Twenty-nine immunosuppressed organ transplant recipients underwent treatment of basal cell or squamous cell carcinoma by Mohs or excisional surgery, with a total of 85 wounds. Wounds were evaluated postoperatively at early (average 12.9 days) and late (average 75.8 days) time points. Endpoints for all wounds included infection, hypertrophic granulation tissue, and hypertrophic scarring. Reconstructed wounds were also evaluated for dehiscence.

Eleven patients taking oral acitretin had 41 wounds, of which 33 were reconstructed and 8 healed by second intention. The 18 patients not taking acitretin (control group) had a total of 44 wounds, of which 33 were reconstructed and 11 healed by second intention. There were no statistically significant differences between the acitretin group and the control group in the incidences of infection, dehiscence, hypertrophic granulation tissue, or hypertrophic scarring at early or late evaluation points.

Systemic acitretin chemoprophylaxis does not appear to increase the risk of wound healing complications in organ transplant recipients.