Current use of steroids in management of abnormal raised skin scars

Jalali, Morteza; Bayat, Ardeshir

doi:10.1016/s1479-666x(07)80045-x

Cited by 94 publications

(59 citation statements)

References 19 publications

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“…Even though no satisfactory explanation has been found for this phenomenon, this worsening of the animal general condition may have contributed to delay wound healing. Contrary to some studies 3,8 in which there has been body weight loss and interference in wound healing process after seven weeks, in this study, the follow-up period of the mice was a lot shorter than those that had been described, and there was a reduction in body weight and skin wound healing resistance as early as the first week of corticoid administration.…”

Section: Upon Histological Assessment It Was Verified Thatcontrasting

confidence: 81%

“…Following other authors 7,13 , the administration of the drug was initiated in the preoperative phase and continued until the day the animals were killed. According to literature 7,8 , when corticosteroids are administered before surgery and maintained postoperatively, their harmful effects are more evident.…”

Section: Upon Histological Assessment It Was Verified Thatmentioning

confidence: 99%

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Influence of local or systemic corticosteroids on skin wound healing resistance

Alberti¹,

Vasconcellos

Petroianu³

2012

Acta Cir. Bras.

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PURPOSE:To compare the resistance of skin wound healing of mice submitted to local or systemic hydrocortisone administration, in different postoperative periods. METHODS:An incision and suture was performed on the thoracic skin of 130 male mice: Group 1 (n = 10) resistance of the integer skin; Group 2 (n = 30) submitted only to skin incision and suture; Group 3 (n = 30) skin incision and suture followed by administration of saline fluid; Group 4 (n = 30) skin incision and suture followed by administration of local hydrocortisone; Group 5 (n = 30) skin incision and suture followed by administration of systemic hydrocortisone. The resistance of the wound healing and the weight of the animals were studied on the seventh, 14 th and 21 st postoperative days. Histological examination was also performed. RESULTS:The mice that received corticoid (groups 4 and 5) presented significant decreasing on their weight (p = 0.02). The Groups 3, 4 and 5 showed lower scar resistance than Group 2 on the seventh postoperative day (p < 0.05). On the 14 th and 21 st days, there was no difference on the skin would healing resistance (p > 0.05). CONCLUSION:Administration of hydrocortisone in mice is responsible for weight decreasing and reduction of the skin wound healing resistance during the first postoperative week. MÉTODOS:Foram estudados 130 camundongos machos submetidos à incisão e sutura de pele da região dorsal do tórax: Grupo 1 (n = 10) resistência da pele íntegra; Grupo 2 (n = 30) incisão da pele e sutura, sem administração de corticóide; Grupo 3 (n = 30) incisão da pele e sutura, seguidas de injeção local de solução salina; Grupo 4 (n = 30) incisão da pele e sutura, seguidas de injeção local de hidrocortisona e Grupo 5 (n = 30) incisão da pele e sutura, seguidas de injeção intraperitoneal de hidrocortisona. Foram avaliadas a resistência cicatricial da pele e a variação ponderal no sétimo, 14º e 21º dias pós-operatórios, bem como sua histologia. RESULTADOS:Os camundongos que receberam hidrocortisona tiveram decréscimo ponderal (p = 0,02). Quanto à resistência cicatricial da pele, os Grupos 3, 4 e 5 apresentaram valor inferior ao Grupo 2, no sétimo dia pós-operatório (p = 0,031). No 14º e 21º dias, não houve diferença entre as tensões cicatriciais.CONCLUSÃO: A administração de hidrocortisona provoca redução ponderal em camundongos e a resistência cicatricial cutânea é menor na primeira semana pós-operatória.

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Section: Upon Histological Assessment It Was Verified Thatcontrasting

confidence: 81%

Section: Upon Histological Assessment It Was Verified Thatmentioning

confidence: 99%

Influence of local or systemic corticosteroids on skin wound healing resistance

Alberti¹,

Vasconcellos

Petroianu³

2012

Acta Cir. Bras.

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“…Most of the known effects of corticosteroids are thought to result primarily from its suppressive effects on the inflammatory process in the wound (93), and secondarily from diminished collagen and glycosaminoglycan synthesis, inhibition of fibroblast growth (107) and enhanced collagen and fibroblast degeneration (108). Two or three injections of triamcinolone acetonide (TAC, 10 to 40 mg/mL) are usually sufficient, although occasionally injections are continued for 6 months or more (106). Response rates have been highly variable, with figures ranging from 50% to 100%, and a recurrence rate of 9% to 50% (109).…”

Section: Current Treatment Strategiesmentioning

confidence: 99%

Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies

Gauglitz

Körting

Pavicic

et al. 2010

Mol Med

1,151

1,012

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Excessive scars form as a result of aberrations of physiologic wound healing and may arise following any insult to the deep dermis. By causing pain, pruritus and contractures, excessive scarring significantly affects the patient's quality of life, both physically and psychologically. Multiple studies on hypertrophic scar and keloid formation have been conducted for decades and have led to a plethora of therapeutic strategies to prevent or attenuate excessive scar formation. However, most therapeutic approaches remain clinically unsatisfactory, most likely owing to poor understanding of the complex mechanisms underlying the processes of scarring and wound contraction. In this review we summarize the current understanding of the pathophysiology underlying keloid and hypertrophic scar formation and discuss established treatments and novel therapeutic strategies.

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“…Historically, a number of treatment modalities such as cryotherapy, 23 interferon 24 and veramapril 25 have been utilized for treating KD, with inconsistent levels of success. However, more recent treatments such as lasers, 26 intralesional steroid injections, 27 silicone gel, 28 5-fluorouracil (FU), 29 radiotherapy, 30 bleomycin, 31 imiquimod, 32 photodynamic therapy (PDT), 33 electrical stimulation (ES) 34 and surgery 35 have also been used in the management of KD, but not all have shown efficacy in ethnic pigmented skin. These commonly available and newly emerging treatment modalities (Table 3) will be discussed in detail below.…”

Section: Overview Of Findingsmentioning

confidence: 99%

Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature

Uddin

Bayat

2013

Br J Dermatol

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SummaryKeloid disease (KD) is a common, benign, dermal fibroproliferative growth of unknown aetiology. Lesions tend to grow over time; they often recur following therapy and do not regress spontaneously. KD causes considerable discomfort due to pain, pruritus and inflammation, and a significant psychosocial impact with reduced quality of life. It is unique to humans and occurrence is higher in individuals with dark, pigmented, ethnic skin. There is a strong familial heritability, with a high ethnic predisposition in individuals of African, Asian and Hispanic descent. High recurrence rates and unknown resolution rates present a major problem for both the patient and clinician. Many treatment modalities exist; however, there is no single advocated therapy. Therefore, the aim of this review was to explore the most current literature regarding the range of treatment options for KD and to offer a structured approach in the management of KD, based on evidence and experience, to aid clinicians in their current practice. A focused history involving careful evaluation of the patient's symptoms, signs, quality of life and psychosocial well-being should direct targeted therapy, complemented with regular follow-up and re-evaluation. Many treatment modalities, such as intralesional steroid injection, silicone gel application, cryotherapy, lasers, 5-fluorouracil and, relatively recently, photodynamic therapy, are currently being used in clinical practice for the management of KD. Combination therapies have also been shown to be beneficial. However, there is a lack of robust, randomized, level-one, evidence-controlled trials evaluating these treatment options. Management of KD in ethnic pigmented skin remains a clinical challenge. Thus, a strategic approach with structured assessment, targeted therapy and focus on prevention of recurrence is highly recommended. Quality evidence is essential in order to tailor treatment effectively for the ethnic patient presenting with KD.What's already known about this topic?• Keloid disease (KD) is a common, benign, fibroproliferative tumour of unknown origin.• With high recurrence rates, treatment of KD remains a challenge for both the patient and clinician.• With lack of level-one evidence, there is no single advocated therapy.What does this study add?• A structured strategic approach for management of KD by utilizing a focused history, targeted therapy and regular follow-up of the patient.• Patients' symptoms, signs, quality of life and psychosocial well-being should be carefully evaluated and managed.

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Current use of steroids in management of abnormal raised skin scars

Cited by 94 publications

References 19 publications

Influence of local or systemic corticosteroids on skin wound healing resistance

Influence of local or systemic corticosteroids on skin wound healing resistance

Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies

Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature

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