Successful Treatment of Earlobe Keloids with Imiquimod after Tangential Shave Excision

Stashower, Mitchell E.

doi:10.1111/j.1524-4725.2006.32077.x

Cited by 51 publications

(46 citation statements)

References 21 publications

(24 reference statements)

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“…The postsurgical use of imiquimod 5% cream has recently been reported 24 . All 4 patients were successfully treated without recurrence for 12 months after their final excision.…”

Section: Discussionmentioning

confidence: 99%

Surgery and Perioperative Intralesional Corticosteroid Injection for Treating Earlobe Keloids: A Korean Experience

et al. 2009

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Background:The aesthetic implications of ear keloids, which affect people of all races, are serious and the treatment of earlobe keloids is known to be difficult. The high rate of recurrence following excision alone has led to investigating various types of adjuvant therapy, including intralesional corticosteroid injection. Objective: We evaluated the efficacy of excision combined with perioperative intralesional triamcinolone acetonide injection for treating earlobe keloids of Korean patients. Methods: From 1997 to 2006, eighteen keloids on the earlobes of fifteen Korean patients were treated. The patient age ranged from 15 to 32 years (mean age: 24 years). All the patients were female and the keloids occurred after ear piercing. Preoperative intralesional triamcinolone acetonide (TA) injection was administered twice at a 1-month interval. Postoperative intralesional TA injections were given every 1 month for several months, depending on the patient's clinical progress. Results: The follow-up period ranged from 4 to 42 months (mean: 18.5 months). After the surgery, TA intralesional injections were given 2 to 13 times (mean: 5.2 times). Of the treated keloids, eleven showed good results (61.1%) and three recurred (16.6%). No complications from the TA intralesional injection were observed. Conclusion: Among the various treatments for earlobe keloids, we suggest that excision with corticosteroid intralesional injection can be used as the first line therapy when considering its effect and economic advantage. (Ann Dermatol 21(3) 221∼225, 2009)

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“…The postsurgical use of imiquimod 5% cream has recently been reported 24 . All 4 patients were successfully treated without recurrence for 12 months after their final excision.…”

Section: Discussionmentioning

confidence: 99%

Surgery and Perioperative Intralesional Corticosteroid Injection for Treating Earlobe Keloids: A Korean Experience

et al. 2009

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“…A case series also demonstrated no evidence of recurrence in patients with KD for up to 12 months when applying imiquimod daily for 6-8 weeks. 71 However, another study failed to demonstrate the utility of imiquimod in surgically excised trunk KD. 72 …”

Section: Imiquimodmentioning

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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“…[15][16][17][18][19][20] Interestingly, however, this same success was not seen in truncal keloids, with a reported high rate of recurrence after surgical excision and imiquimod therapy. 21 Unfortunately, a prospective, doubleblind, placebo-controlled trial failed to demonstrate any significant reduction in keloid recurrence rates when using imiquimod versus placebo after keloid excision.…”

Section: Discussion Of Findings and Relevant Literature Topical Scar mentioning

confidence: 99%

Emerging Therapies for Scar Prevention

Block

Gosain

2015

Advances in Wound Care

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Significance: There are *12 million traumatic lacerations treated in the United States emergency rooms each year, 250 million surgical incisions created worldwide every year, and 11 million burns severe enough to warrant medical treatment worldwide. In the United States, over $20 billion dollars per year are spent on the treatment and management of scars. Recent Advances: Investigations into the management of scar therapies over the last decade have advanced our understanding related to the care of cutaneous scars. Scar treatment methods are presented including topical, intralesional, and mechanical therapies in addition to cryotherapy, radiotherapy, and laser therapy. Critical Issues: Current treatment options for scars have significant limitations. This review presents the current and emerging therapies available for scar management and the scientific evidence for scar management is discussed. Future Directions: Based upon our new understanding of scar formation, innovative scar therapies are being developed. Additional research on the basic science of scar formation will lead to additional advances and novel therapies for the treatment of cutaneous scars.

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Successful Treatment of Earlobe Keloids with Imiquimod after Tangential Shave Excision

Abstract: In this pilot study, imiquimod 5% cream following tangential shave excision was efficacious for the treatment of earlobe keloids. Further study is warranted to confirm the utility of imiquimod 5% cream in the treatment of earlobe keloids, as illustrated herein.

Cited by 51 publications

References 21 publications

Surgery and Perioperative Intralesional Corticosteroid Injection for Treating Earlobe Keloids: A Korean Experience

Surgery and Perioperative Intralesional Corticosteroid Injection for Treating Earlobe Keloids: A Korean Experience

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

Emerging Therapies for Scar Prevention

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