Treatment of Keloids Using Plasma Skin Regeneration Combined with Radiation Therapy Under the Evaluation of Patient and Observer Scar Assessment Scale

Abstract

Keloids are caused by uncontrolled excessive proliferation of fibrous tissue. Multiple treatment strategies including steroid injection, surgical excision, laser therapy and radiation therapy have been reported. Few studies have evaluated the performance of plasma skin regeneration (PSR) in the treatment of keloid. This study aimed to evaluate the effectiveness of PSR combined with radiation therapy for keloids on different body parts. Patients and Methods: A total of 71 patients with 98 keloids were enrolled in this study. Keloids <4 mm thick underwent single-dose PSR, while keloids ≥4 mm thick were administered compound betamethasone injection beforehand. Radiation therapy was administered after 24 hours and again 7 days later after PSR. The outcome was evaluated using the patient and observer scar assessment scale at 12 months post-treatment. Results: Patient-reported average scores for all keloids significantly decreased from 35.05 ±9.94 to 21.84±7.04 (p < 0.05). Keloids on face and neck, chest, and back responded better than those on shoulders and limbs. The recurrence rate was observed to be 15.3% (15 out of 98). Adverse effects were mild. Conclusion: PSR combined with radiation therapy is an effective and safe strategy to treat keloids. Location could be a factor that affects curative effects.

Keloid Treatment Using Plasma Exeresis: A Pilot Trial Study

“…However, side effects after the treatment, including radiation dermatitis, hyper-and hypopigmentation, and scar recurrence were also noted. 23 For this reason, we figured out that multi-session therapies with omitting the radiotherapy were more successful.…”

“…Previous surveys reported recurrence of the condition via methods like surgical excision or laser therapy . 26 Although recent studies have mentioned combination therapies for keloids like CO2 laser ablation followed by steroid injection, 27 platelet-rich plasma injection with surgical excision, 28 or plasma therapy with radiation therapy, 23 there is no consensus in this regard, and sometimes these combination therapies have led to unsuccessful outcomes or adverse effects. Choosing an effective monotherapy method can be beneficial in this regard.…”

Efficacy of pulsed dye laser combined with fractional CO2 laser in the treatment of pediatric burn scars

“…The Patient and Observer Scar Assessment Scale (POSAS) (patient section including pain, itching, color, stiffness, thickness, and irregularity; observer section including vascularization, pigmentation, thickness, relief, pliability, and surface area) was used as the main clinical outcome, as described elsewhere. 15,16 The assessment of POSAS was performed before the treatment as well as 6 months after the final treatment.…”

Ulvan-Based Nanofibrous Patches Enhance Wound Healing of Skin Trauma Resulting from Cryosurgical Treatment of Keloids

“…Clinical practice guidelines for the treatment of skin trauma resulting from cryosurgery include the application of a variety of topical agents [8,9], with surveys suggesting that topical products, such as sprays and gels, should be used to promote tissue repair. The main disadvantage of the application of such products is the non-controlled dosage, which frequently leads to incomplete healing [10,11]. In contrast, topical patches, which have not yet been studied for the wound healing of patients' skin trauma resulting after treatment of keloids with cryosurgery, could offer the advantage of either the constant contact with bioactive wound dressings or the controlled delivery of anti-inflammatory and wound healing agents [12][13][14][15][16][17].…”