Imiquimod Treatment of Exuberant Granulation Tissue in a Nonhealing Diabetic Ulcer

Pulsed-Dye Laser Treatment of Nonhealing Chronic Ulcer With Hypergranulation Tissue

“…It remains to be seen if PDL will be equally effective for treating CUHGT that resulted from other causes, such as diabetic ulcer or nonhealing wounds after endotracheal intubation and gastrostomy tube placements. Based on our case series, work by Lain and Carrington, 9 and the understanding of normal granulation tissue development, we hypothesize that excessive angiogenesis plays a major role in the formation of hypergranulation tissue. Targeting the vasculature of the hypergranulation tissue seems to be an effective therapeutic strategy for the treatment of CUHGT.…”

Exuberant granulation tissue successfully treated with ingenol mebutate. Two cases report

“…Formation of exuberant granulation tissue is an undesirable effect in wound healing that sometimes is difficult to solve (Lain & Carrington, ). It is described in literature that ingenol mebutate produces a reduction of vascularization in actinic keratosis demonstrated by a decrease of median hemoglobin levels in treated areas (Bobyr et al, ; Cantisani et al, ).…”

“…It is reported in the literature the successfully use of imiquimod 5% in exuberant granulation tissue as an alternative option of treatment when conventional treatment with chemical cauterizing agents or debridement therapy have failed (Lain & Carrington, ). At our knowledge, these are the first two cases reported of exuberant granulation tissue successfully treated with ingenol mebutate gel in three consecutive days.…”

Imiquimod as an antiaging agent

“…5,7 However, others have shown a downregulation in imiquimod-treated skin of MMP-9, basic fibroblast growth factor, and vascular endothelial growth factor with a corresponding up-regulation of tissue inhibitor of MMP-1. [8][9][10] The cytokine milieu induced by imiquimod is undoubtedly complex, but these latter findings could explain the reduction in clinical and histologic photoaging by demonstrating an inhibition of dermal matrix degradation, thus, allowing for repair. It is not clear to what degree this response is specific for imiquimodinduced inflammation.…”