Imiquimod Treatment of Exuberant Granulation Tissue in a Nonhealing Diabetic Ulcer

Does Imiquimod Histologically Rejuvenate Ultraviolet Radiation–Damaged Skin?

“…Over the past years, it has been demonstrated to improve scar cosmesis following postsurgical wounds 11 . Moreover, there has been an increasing number of experimental and clinical studies using imiquimod for dermal disorders 12,13 . Based on these considerations, imiquimod represents a promising option for the treatment of skin modifications caused by intrinsic or extrinsic agents.…”

“…What are the mechanisms leading to these clinical and histologic outcomes? Several studies have indicated that imiquimod may affect, through the direct or indirect release of local cytokines (including IFN‐α, TGF‐β, FGF‐2, IL‐4), the production and breakdown of dermal matrix and collagen fibers 12,13 . The exact pathways leading to these effects are still unclear, however.…”

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, ).…”