LAUSR

hCG diet to avoid unnecessary drug discontinuation. ISO could be reinstituted only when the b-hCG level is normalized on careful reassessment. Despite the general concept of ISO teratogenicity, the risk of MM secondary to periconceptional exposure to ISO may be lower than originally reported. These data should be carefully interpreted and clearly explained to expecting parents. Women with childbearing potential should be informed about amenorrhea as a potential side effect of ISO. They should be asked about unusual diet regimens when presented with a positive test of early conception. Actually, the level of b-hCG in true pregnancy is much higher than in those on a b-hCG diet. Those patients should be informed about the possibility of misinterpreted pregnancy test. In brief, dermatologists should discuss concrete current knowledge to help their patients, who would not opt for pregnancy termination, in their risky decision. In earlier studies from Canada and the US, the percentage of women who became pregnant while on ISO and chose to terminate their pregnancy was 84 and 72%, respectively. Others reported that percentage as low as 26.6%. Till further studies assess the true risk of ISO-related MM for each trimester, ISO-planned patients have to adhere to the pretreatment counseling programs to reduce the risk of an unplanned or suspected pregnancy. Meanwhile, an updated proposed acne algorithm treatment plan was recommended, taking into consideration countries or states where abortion is illegal.