A Clinical Study for the Management of Ear Pinna Keloid by Ksharsutra and Agnikarma

Amrut, Salunke; Nakanekar, Amit; Madhukar, Lahankar; Hema, Kolpe; Shital, Borkundwar; Tantra, Shalakya; Podar, R. A.

doi:10.7897/2277-4343.05353

Cited by 2 publications

(1 citation statement)

References 7 publications

(7 reference statements)

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“…We identified 16 other treatment regimens for recalcitrant auricular keloids including (1) surgical excision and imiquimod; 12,45 (2) radiofrequency ablation; 46,47 (3) surgical excision, mitomycin C, and steroids; 48 (5) surgical excision, steroid injections, radiation, and compression; 13 (6) cryosurgery; 49 (7) laser and steroids; 50,51 (8) surgical excision and CO 2 laser; 52 (9) surgical excision and mitomycin C; 53 (10) collagenase injections and compression; 54 (11) ksharsutra and agnikarma; 55 (12) verapamil and compression; 56 (13) surgical excision þ verapamil; 57 (14) surgical excision and plateletrich plasma; (15) surgical excision, steroid injections, and compression; 14 and (16) surgical excision, compression, and steroid tape. 58 Although some of these treatments show promising results, there is limited data and we did not include them in our analysis.…”

Section: Other Treatmentsmentioning

confidence: 99%

What Do We Know About Treating Recalcitrant Auricular Keloids? A Systematic Review and Meta-Analysis

et al. 2021

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Background: Recalcitrant auricular keloids are keloids that have recurred after any previous treatment. They have been shown to have an increased likelihood of recurrence. There is no consensus on how best to treat recalcitrant auricular keloids. Here, we perform the first systematic review and meta-analysis investigating the evidence for treating recalcitrant auricular keloids. Methods: We searched MEDLINE, EMBASE, CINAHL, and EBM Reviews using specific keywords. Prespecified inclusion and exclusion criteria were used to assess article eligibility. Data were extracted for number of recalcitrant keloids, treatment modality, recurrence, and minimum follow-up time. Included articles were stratified by treatment and assigned a level of evidence (LOE) based on the Oxford Centre for Evidence-Based Medicine guidelines. A meta-analysis was performed to estimate recurrence rates with 95% confidence intervals for each treatment modality. Results: A total of 887 unique articles were identified and 13 included. Eleven were LOE III and 2 were LOE IV. Recurrence rates were found to be 9% (95% CI: 3%-25%) for excision with adjuvant brachytherapy, 14% (95% CI: 12%-17%) for excision with adjuvant compression therapy, 17% (95% CI: 3%-56%) for excision with adjuvant external beam radiation, and 18% (95% CI: 4%-53%) for excision with adjuvant steroid injections. No statistical significant difference was found. Conclusions: Data for treatment of auricular keloids are heterogeneous with few high-quality studies. Excision with adjuvant brachytherapy has the lowest recurrence rate in our analysis. Narrow confidence intervals reported here for brachytherapy and compression therapy may help surgeons more confidently recommend either of these treatment modalities to patients.

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Section: Other Treatmentsmentioning

confidence: 99%

What Do We Know About Treating Recalcitrant Auricular Keloids? A Systematic Review and Meta-Analysis

et al. 2021

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Keloid treatments: an evidence-based systematic review of recent advances

Walsh

Pontes

et al. 2023

Syst Rev

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Background Keloids are pathologic scars that pose a significant functional and cosmetic burden. They are challenging to treat, despite the multitude of treatment modalities currently available. Objective The aim of this study was to conduct an evidence-based review of all prospective data regarding keloid treatments published between 2010 and 2020. Methods A systematic literature search of PubMed (National Library of Medicine), Embase (Elsevier), and Cochrane Library (Wiley) was performed in November of 2020. Search strategies with the keywords “keloid” and “treatment” were performed by a medical librarian. The search was limited to prospective studies that were peer-reviewed, reported on clinical outcomes of keloid therapies, and were published in the English language between January 1, 2010, and November 24, 2020. Results A total of 3462 unique citations were identified, of which 108 studies met inclusion criteria. Current literature supports silicone gel or sheeting with corticosteroid injections as first-line therapy for keloids. Adjuvant intralesional 5-fluorouracil (5-FU), bleomycin, or verapamil can be considered, although mixed results have been reported with each. Laser therapy can be used in combination with intralesional corticosteroids or topical steroids with occlusion to improve drug penetration. Excision of keloids with immediate post-excision radiation therapy is an effective option for recalcitrant lesions. Finally, silicone sheeting and pressure therapy have evidence for reducing keloid recurrence. Conclusions This review was limited by heterogeneity of subject characteristics and study outcome measures, small sample sizes, and inconsistent study designs. Larger and more robust controlled studies are necessary to further understand the variety of existing and emerging keloid treatments, including corticosteroids, cryotherapy, intralesional injections, lasers, photodynamic therapy, excision and radiation, pressure dressings, and others.

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A Clinical Study for the Management of Ear Pinna Keloid by Ksharsutra and Agnikarma

Cited by 2 publications

References 7 publications

What Do We Know About Treating Recalcitrant Auricular Keloids? A Systematic Review and Meta-Analysis

What Do We Know About Treating Recalcitrant Auricular Keloids? A Systematic Review and Meta-Analysis

Keloid treatments: an evidence-based systematic review of recent advances

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