Combined intralesional triamcinolone acetonide and platelet rich plasma versus intralesional triamcinolone acetonide alone in treatment of keloids

Hewedy, El-Sayed Shaaban; Ibrahim, Wesam A.; Mohamed, Wesam; Hegab, Doaa Salah

doi:10.1080/09546634.2020.1730742

Cited by 23 publications

(22 citation statements)

References 28 publications

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“…The mean percent of improvement was 84% and there was a significant improvement in height and consistency of keloids but there was insignificant improvement in pigmentation and vascularity using VSS. Furthermore, Hewedy et al, 29 assessed the efficacy of PRP as a synergistic treatment modality for keloids in combination with TAC and reported successful results.…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin and platelet rich plasma as innovative therapeutic modalities for keloids

Neinaa

Elsayed²,

Mohamed

et al. 2021

Dermatologic Therapy

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Keloids characterize a definitely challenging type of cutaneous scars for which a diversity of therapeutic modalities has been suggested. The aim of this work was to compare the therapeutic efficacy of intralesional injection of botulinum toxin type‐A (BTX‐A), platelet rich plasma (PRP), and triamcinolone acetonide (TAC) in keloids. A total of 60 keloids patients were enrolled and divided randomly into three equal groups. Group I treated by intralesional BTX‐A injection, group II treated by intralesional PRP injection, and group III treated by intralesional TAC injection. Clinical assessment was done by Vancouver Scar Scale (VSS), Verbal Rating Scale (VRS), and dermoscopic examination. Additionally, histopathology and immunohistochemistry of connective tissue growth factor (CTGF) expression were evaluated. The results of this study revealed significant improvement of both VSS and VRS in response to all treatment modalities. There was significant improvement of VSS in BTX‐A and PRP groups more than TAC group. However, no significant difference observed between BTX‐A and PRP groups. Immunohistochemical examination showed significant decrease of CTGF expression after treatment in BTX‐A and PRP groups more than TAC group. In conclusion, both BTX‐A and PRP could yield a chance for cosmetically better outcomes in keloids treatment than conventional TAC injection.

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Section: Discussionmentioning

confidence: 99%

Botulinum toxin and platelet rich plasma as innovative therapeutic modalities for keloids

Neinaa

Elsayed²,

Mohamed

et al. 2021

Dermatologic Therapy

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“…The sample size was calculated considering a significance level of 0.05 and 80% power to obtain the means of improvement at three months postoperatively using the Vancouver Scar Scale (corticoid group: mean = 1.95; SD = 1.84) based on the paper by HEWEDY et al . [ 63 ]. Due to the lack of data in the literature regarding the study group, we estimated the same variability found in Group 1 (G1 1.95 vs. G2 0.25, difference of 1.7).…”

Section: Methodsmentioning

confidence: 99%

Effect of the combination of photobiomodulation therapy and the intralesional administration of corticoid in the preoperative and postoperative periods of keloid surgery: A randomized, controlled, double-blind trial protocol study

et al. 2022

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Keloid scars are characterized by the excessive proliferation of fibroblasts and an imbalance between the production and degradation of collagen, leading to its buildup in the dermis. There is no “gold standard” treatment for this condition, and the recurrence is frequent after surgical procedures removal. In vitro studies have demonstrated that photobiomodulation (PBM) using the blue wavelength reduces the proliferation speed and the number of fibroblasts as well as the expression of TGF-β. There are no protocols studied and established for the treatment of keloids with blue LED. Therefore, the purpose of this study is to determine the effects of the combination of PBM with blue light and the intralesional administration of the corticoid triamcinolone hexacetonide on the quality of the remaining scar by Vancouver Scar Scale in the postoperative period of keloid surgery. A randomized, controlled, double-blind, clinical trial will be conducted involving two groups: 1) Sham (n = 29): intralesional administration of corticoid (IAC) and sham PBM in the preoperative and postoperative periods of keloid removal surgery; and 2) active PBM combined with IAC (n = 29) in the preoperative and postoperative periods of keloid removal surgery. Transcutaneous PBM will be performed on the keloid region in the preoperative period and on the remaining scar in the postoperative period using blue LED (470 nm, 400 mW, 4J per point on 10 linear points). The patients will answer two questionnaires: one for the assessment of quality of life (Qualifibro-UNIFESP) and one for the assessment of satisfaction with the scar (PSAQ). The team of five plastic surgeons will answer the Vancouver Scar Scale (VSS). All questionnaires will be administered one, three, six, and twelve months postoperatively. The keloids will be molded in silicone prior to the onset of treatment and prior to excision to assess pre-treatment and post-treatment size. The same will be performed for the remaining scar at one, three, six, and twelve months postoperatively. The removed keloid will be submitted to histopathological analysis for the determination of the quantity of fibroblasts, the organization and distribution of collagen (picrosirius staining), and the genic expression of TGF-β (qPCR). All data will be submitted to statistical analysis. Trial registration: This study is registered in ClinicalTrials.gov (ID: NCT04824612).

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“…Platelet‐rich plasma (PRP) is an autologous platelet concentrate that had been shown to improve collagen structural organization in scars and decrease pain and functional disabilities associated with scar tissue deposition 58 …”

Section: Emerging Treatmentsmentioning

confidence: 99%

Update on management of keloid and hypertrophic scars: A systemic review

Elsaie

2021

J of Cosmetic Dermatology

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Numerous therapeutic strategies have been described for prevention and reduction of hypertrophic scars and keloids, but none of the treatments is effective in all patients. No universal consensus in treatment regimen has been established, and there is limited evidence‐based literature to guide the correct management. The process of scar development is complex and requires deeper understanding of the molecular mechanisms that cause their development and recurrences. Despite many available modes of targeting keloid and hypertrophic scars, yet they remain an ongoing challenge to patients and clinicians. To date, no one therapy has been universally accepted as the gold standard for the treatment of all excessive scars nor has the capability of complete scar resolution The search of literature included peer‐reviewed articles including clinical trials and scientific reviews. Literature was identified from electronic databases (MEDLINE/PubMed) through May 2021 and references of respective articles and only the articles published in English language were included.

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Combined intralesional triamcinolone acetonide and platelet rich plasma versus intralesional triamcinolone acetonide alone in treatment of keloids

Cited by 23 publications

References 28 publications

Botulinum toxin and platelet rich plasma as innovative therapeutic modalities for keloids

Botulinum toxin and platelet rich plasma as innovative therapeutic modalities for keloids

Effect of the combination of photobiomodulation therapy and the intralesional administration of corticoid in the preoperative and postoperative periods of keloid surgery: A randomized, controlled, double-blind trial protocol study

Update on management of keloid and hypertrophic scars: A systemic review

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