Efficacy of 2 Representative Topical Agents to Prevent Keloid Recurrence After Surgical Excision

Shin, Jin Yong; Yun, Seok-Kweon; Roh, Si-Gyun; Lee, Nae-Ho; Yang, Kyung‐Moo

doi:10.1016/j.joms.2016.10.009

Cited by 18 publications

(21 citation statements)

References 32 publications

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“…150 MMC inhibits nucleic acid and protein synthesis and thereby inhibits cell proliferation. 151 MMC has been shown to hinder proliferation of human cultured fibroblasts in vitro 152 and reduce scar formation in vivo. 153 In a prospective experimental study, topical application of MMC impeded wound healing in rats within the first month after treatment; however, three months after treatment, both treated and untreated wounds displayed similar histological characteristics.…”

Section: Emerging Treatmentsmentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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Keloids are pathological scars that grow over time and extend beyond the initial site of injury after impaired wound healing. These scars frequently recur and rarely regress. They are aesthetically disfiguring, can cause pain, itching, discomfort as well as psychological stress, often affecting quality of life. Many treatment modalities, including surgical and non-surgical, have been explored and have been reported to be beneficial; however, none have been absolutely satisfactory or optimal for the treatment of all keloid subtypes to date. This poses a major challenge to clinicians. Often, a combinational therapeutic approach appears to offer the best results with higher patient satisfaction compared to monotherapy. The aetiopathogenesis of keloids is not fully elucidated; however, with recent advances in molecular biology and genetics, insight is being gained on the complex process of scar formation and hence new therapeutic and management options for keloids. In this paper, we explore the literature and summarise the general concepts surrounding keloid development and review both current (corticosteroids, surgical excision, silicone-based products, pressure therapy, radiotherapy, cryotherapy, laser therapy, imiquimod and 5-fluorouracil) and emerging (stem cell therapy, mitomycin C, verapamil, interferons, bleomycin, botulinum toxin type A and angiotensin-converting enzyme inhibitors) treatments. Increased knowledge and understanding in this area may potentially lead to the discovery and development of novel therapeutic options that are more efficacious for all keloid types. Lay Summary [Formula: see text] Keloids are problematic scars that are difficult to treat and manage. The aetiopathogenesis of keloids is not clear; however, recent advances in molecular biology and genetics are beginning to shed light on the underlying mechanisms implicated in keloid scar formation which will hopefully lead to the development of treatment options for all keloid types. This review summarises current and emerging therapies.

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Section: Emerging Treatmentsmentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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“…The topical treatment was also associated with local skin reactions, including erythema, erosion, and crusting . A meta‐analysis in 2017 showed that the estimated keloid recurrence rate in patients undergoing post‐surgical imiquimod cream treatment was 24.7% …”

Section: Current and Emerging Pharmaceuticals In Clinical Keloid Manamentioning

confidence: 99%

“…33 A meta-analysis in 2017 showed that the estimated keloid recurrence rate in patients undergoing post-surgical imiquimod cream treatment was 24.7%. 34 IFN-γ and IFN-α2b are controversial keloid therapies perhaps because of protocol differences between studies. Intralesional IFN-γ injections (0.01 or 0.1 mg) thrice a week for 3 weeks reduced the height of keloid sites by 30.4% compared with 1.1% in control sites; this effect was associated with reductions in thickened collagen bundles and active dermal fibroblasts.…”

Section: Immunotherapiesmentioning

confidence: 99%

Managing keloid scars: From radiation therapy to actual and potential drug deliveries

Huang

Liu

You

et al. 2019

International Wound Journal

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The aetiology of keloids is becoming clearer, but many questions remain, including about the most optimal treatment. Current therapies include surgical excision, radiotherapy, and various pharmaceutical drugs. However, none of these drugs are keloid‐specific. Moreover, all current interventions are associated with high recurrence rates. Here, we review the pharmaceutical interventions that are currently available. All are based on the fact that keloids are an expanding solid mass with intense chronic inflammation at its advancing edges. Consequently, current pharmaceuticals aim to reduce the mass and/or symptoms of keloids, similar to surgery and radiotherapy. They include chemotherapies, immunotherapies, volume‐reducing therapies, and anti‐inflammatory therapies. We also describe new advances in keloid pharmaceuticals. They include drugs that were designed to treat systemic diseases such as hypertension or breast cancer but were found to also treat keloids. Furthermore, recent progress in genetic, epigenetic, and stem cell therapies suggests that they could become useful in the keloid field. This review of pharmaceutical advances will hopefully promote additional research and the development of effective and specific pharmaceuticals for keloids.

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“…After excision, gauze soaked with MC at a dose of 1mg/ml is generally applied for 3-5 minutes postoperatively and again at three weeks post-op. Keloid recurrence rates after surgical excision plus MC combination therapy have been shown to average 16.5% with a mean follow-up period of six-month duration [ 11 ]. There is potential for dose-dependent adverse effects with MC and it should be carefully dosed at 1mg/ml to avoid these potential complications [ 11 ].…”

Section: Reviewmentioning

confidence: 99%

“…Keloid recurrence rates after surgical excision plus MC combination therapy have been shown to average 16.5% with a mean follow-up period of six-month duration [ 11 ]. There is potential for dose-dependent adverse effects with MC and it should be carefully dosed at 1mg/ml to avoid these potential complications [ 11 ]. Additionally, MC should never be used in pregnant patients due to the potential for harm to the developing fetus [ 12 ].…”

Section: Reviewmentioning

confidence: 99%

Keloid Scars: An Updated Review of Combination Therapies

Thornton

García

Hoyer

et al. 2021

Cureus

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Keloid scars are a common yet poorly understood complication of wound healing that can cause a diminished quality of life. Currently, there is little agreement amongst the medical community regarding the best treatment modality for keloids. For this reason, we have created an updated review of the most successful combination therapies for keloid scars and compared their efficacy based on rates of recurrence following treatment. Additionally, these combination therapies have been compared with intralesional triamcinolone acetonide corticosteroid (TAC), which is considered the mainstay monotherapy for keloids. All combination therapies included in our review were shown to produce superior outcomes than TAC monotherapy. We have also found that certain combination therapies are known to produce superior results when used in specific anatomic locations. Intralesional TAC plus intralesional cryotherapy appeared to have the most promising results for non-auricular keloids, and the authors suggest considering this as a first-line treatment. Additionally, the use of surgical excision plus compression therapy achieved superior results for auricular keloids and should be considered first-line for keloids in these locations.

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Efficacy of 2 Representative Topical Agents to Prevent Keloid Recurrence After Surgical Excision

Cited by 18 publications

References 32 publications

Keloids: Current and emerging therapies

Keloids: Current and emerging therapies

Managing keloid scars: From radiation therapy to actual and potential drug deliveries

Keloid Scars: An Updated Review of Combination Therapies

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