Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes

Oxford University Press (OUP) - Tập 3 - Trang 1-10 - 2015
Aurelia Trisliana Perdanasari1, Matteo Torresetti2, Luca Grassetti2, Fabio Nicoli3, Yi Xin Zhang1, Talal Dashti4, Giovanni Di Benedetto2, Davide Lazzeri4
1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai, P.R. China
2Department of Plastic and Reconstructive Surgery, Marche Polytechnic University Medical School, University Hospital of Ancona, Ancona, Italy
3Department of Plastic Reconstructive and Aesthetic Surgery, University of Rome, Rome, Italy
4Plastic Reconstructive and Aesthetic Surgery Unit, Rome, Italy

Tóm tắt

The aim of this review was to explore the existing body of literature focusing on the intralesional treatments of keloids and hypertrophic scars. A comprehensive systematic review of related articles was conducted across multiple databases. Article selection was limited to those published in the English language between 1950 and 2014. Search terms for the on-line research were “scar(s),” “keloid(s),” “hypertrophic,” “injection,” “intralesional,” and “treatment”. The initial search returned 2548 published articles. After full text review, the final search yielded 11 articles that met inclusion criteria. A total of 14 patient samples in 11 articles were collected. The most frequent intralesional injection treatment studied was triamcinolone (n = 5), followed by bleomycin (n = 3), 5-fluorouracil (n = 2), verapamil (n = 2), cryosurgery, and collagenase. The scar height reduction for all but one study was demonstrated, with acceptable complication and recurrence rate. Only three articles reported a follow-up period longer than 18 months, and only two studies used standardized outcome criteria with a quantitative scale. Although many treatment options have already been described in the literature, there is no universally accepted treatment resulting in permanent hypertrophic or keloid scar ablation. The lack of adequately long-term powered randomized controlled trials does not permit to establish definitive conclusions with implications for routine clinical practice. III/Therapeutic

Tài liệu tham khảo

Tsao SS, Dover JS, Arndt KA, Kaminer MS. Scar management: keloid, hypertrophic, atrophic, and acne scars. Semin Cutan Med Surg. 2002;21(1):46–75.

Carantino I, Florescu IP, Carantino A. Overview about the keloid scars and the elaboration of a non-invasive, unconventional treatment. J Med Life. 2010;3(2):122–7.

Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician. 2009;80(3):253–60.

Naeini FF, Najafian J, Ahmadpour K. Bleomycin tattooing as a promising therapeutic modality in large keloids and hypertrophic scars. Dermatol Surg. 2006;32(8):1023–9. discussion 1029–30.

Ziade M, Domergue S, Batifol D, Jreige R, Sebbane M, Goudot P, et al. Use of botulinum toxin type A to improve treatment of facial wounds: a prospective randomised study. J Plast Reconstr Aesthet Surg. 2013;66(2):209–14.

Jablonka EM, Sherris DA, Gassner HG. Botulinum toxin to minimize facial scarring. Facial Plast Surg. 2012;28(5):525–35.

McCollum PT, Bush JA, James G, Mason T, O'Kane S, McCollum C, et al. Randomized phase II clinical trial of avotermin versus placebo for scar improvement. Br J Surg. 2011;98(7):925–34.

Bush J, Duncan JA, Bond JS, Durani P, So K, Mason T, et al. Scar-improving efficacy of avotermin administered into the wound margins of skin incisions as evaluated by a randomized, double-blind, placebo-controlled, phase II clinical trial. Plast Reconstr Surg. 2010;126(5):1604–15.

Ferguson MW, Duncan J, Bond J, Bush J, Durani P, So K, et al. Prophylactic administration of avotermin for improvement of skin scarring: three double-blind, placebo-controlled, phase I/II studies. Lancet. 2009;373(9671):1264–74.

Ono I, Akasaka Y, Kikuchi R, Sakemoto A, Kamiya T, Yamashita T, et al. Basic fibroblast growth factor reduces scar formation in acute incisional wounds. Wound Repair Regen. 2007;15(5):617–23.

Gassner HG, Brissett AE, Otley CC, Boahene DK, Boggust AJ, Weaver AL, et al. Botulinum toxin to improve facial wound healing: A prospective, blinded, placebo-controlled study. Mayo Clin Proc. 2006;81(8):1023–8.

Wilson AM. Use of botulinum toxin type A to prevent widening of facial scars. Plast Reconstr Surg. 2006;117(6):1758–66.

Sanders KW, Gage-White L, Stucker FJ. Topical mitomycin C in the prevention of keloid scar recurrence. Arch Facial Plast Surg. 2005;7(3):172–5.

Sadeghinia A, Sadeghinia S. Comparison of the efficacy of intralesional triamcinolone acetonide and 5-fluorouracil tattooing for the treatment of keloids. Dermatol Surg. 2012;38(1):104–9.

Anthony ET, Lemonas P, Navsaria HA, Moir GC. The cost effectiveness of intralesional steroid therapy for keloids. Dermatol Surg. 2010;36(10):1624–6.

Xiao Z, Zhang F, Cui Z. Treatment of hypertrophic scars with intralesional botulinum toxin type A injections: a preliminary report. Aesthetic Plast Surg. 2009;33(3):409–12.

Haurani MJ, Foreman K, Yang JJ. Siddiqui A.5-Fluorouracil treatment of problematic scars. Plast Reconstr Surg. 2009;123(1):139–48.

Lee JH, Kim SE, Lee AY. Effects of interferon-alpha2b on keloid treatment with triamcinolone acetonide intralesional injection. Int J Dermatol. 2008;47(2):183–6.

Beuth J, Hunzelmann N, Van Leendert R, Basten R, Noehle M, Schneider B. Safety and efficacy of local administration of contractubex to hypertrophic scars in comparison to corticosteroid treatment. Results of a multicenter, comparative epidemiological cohort study in Germany. In Vivo. 2006;20(2):277–83.

Muneuchi G, Suzuki S, Onodera M, Ito O, Hata Y, Igawa HH. Long-term outcome of intralesional injection of triamcinolone acetonide for the treatment of keloid scars in Asian patients. Scand J Plast Reconstr Surg Hand Surg. 2006;40(2):111–6.

Yosipovitch G, Widijanti Sugeng M, Goon A, Chan YH, Goh CL. A comparison of the combined effect of cryotherapy and corticosteroid injections versus corticosteroids and cryotherapy alone on keloids: a controlled study. J Dermatolog Treat. 2001;12(2):87–90.

Gupta S, Kalra A. Efficacy and safety of intralesional 5-fluorouracil in the treatment of keloids. Dermatology. 2002;204(2):130–2.

Ahmad K. Regression in keloid scar by intralesional injection of papaya milk. Br J Plast Surg. 1998;51(3):261.

Nanda S, Reddy BS. Intralesional 5-fluorouracil as a treatment modality of keloids. Dermatol Surg. 2004;30(1):54–6.

Zhibo X, Miaobo Z. Intralesional botulinum toxin type A injection as a new treatment measure for keloids. Plast Reconstr Surg. 2009;124(5):275e–7e.

Munavalli GS, Smith S, Maslowski JM, Weiss RA. Successful treatment of depressed, distensible acne scars using autologous fibroblasts: a multi-site, prospective, double blind, placebo-controlled clinical trial. Dermatol Surg. 2013;39(8):1226–36.

Mazzola IC, Cantarella G, Mazzola RF. Management of tracheostomy scar by autologous fat transplantation: a minimally invasive new approach. J Craniofac Surg. 2013;24(4):1361–4.

Khan F, Richards K, Rashid RM. Hyaluronic acid filler for a depressed scar. Dermatol Online J. 2012;18(5):15.

Kim JE, Lee OS, Choi J, Son SW, Oh CH. The efficacy of stereoimage optical topometry to evaluate depressed acne scar treatment using cultured autologous fibroblast injection. Dermatol Surg. 2011;37(9):1304–13.

Guisantes E, Fontdevila J, Rodríguez G. Autologous fat grafting for correction of unaesthetic scars. Ann Plast Surg. 2012;69(5):550–4.

Sage RJ, Lopiccolo MC, Liu A, Mahmoud BH, Tierney EP, Kouba DJ. Subcuticular incision versus naturally sourced porcine collagen filler for acne scars: a randomized split-face comparison. Dermatol Surg. 2011;37(4):426–31.

Hasson A, Romero WA. Treatment of facial atrophic scars with Esthélis, a hyaluronic acid filler with polydense cohesive matrix (CPM). J Drugs Dermatol. 2010;9(12):1507–9.

Epstein RE, Spencer JM. Correction of atrophic scars with artefill: an open-label pilot study. J Drugs Dermatol. 2010;9(9):1062–4.

Beer K. A single-center, open-label study on the use of injectable poly-L-lactic acid for the treatment of moderate to severe scarring from acne or varicella. Dermatol Surg. 2007;33 Suppl 2:S159–67.

Barnett JG, Barnett CR. Treatment of acne scars with liquid silicone injections: 30-year perspective. Dermatol Surg. 2005;31(11 Pt 2):1542–9.

Fezza JP. Nonsurgical treatment of cicatricial ectropion with hyaluronic acid filler. Plast Reconstr Surg. 2008;121(3):1009–14.

Gentile P, De Angelis B, Pasin M, Cervelli G, Curcio CB, Floris M, et al. Adipose-derived stromal vascular fraction cells and platelet-rich plasma: basic and clinical evaluation for cell-based therapies in patients with scars on the face. J Craniofac Surg. 2014;25(1):267–72.

Darougheh A, Asilian A, Shariati F. Intralesional triamcinolone alone or in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. Clin Exp Dermatol. 2009;34(2):219–23.

Koc E, Arca E, Surucu B, Kurumlu Z. An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic scars and keloids. Dermatol Surg. 2008;34(11):1507–14.

Berman B, Patel JK, Perez OA, Viera MH, Amini S, Block S, et al. Evaluating the tolerability and efficacy of etanercept compared to triamcinolone acetonide for the intralesional treatment of keloids. J Drugs Dermatol. 2008;7(8):757–61.

Kelemen O, Hegedus G, Kollár L, Menyhei G, Seress L. Morphological analysis of the connective tissue reaction in linear hypertrophic scars treated with intralesional steroid or silicone-gel sheeting. A light and electron microscopic study. Acta Biol Hung. 2008;59(2):129–45.

Ardehali B, Nouraei SA, Van Dam H, Dex E, Wood S, Nduka C. Objective assessment of keloid scars with three-dimensional imaging: quantifying response to intralesional steroid therapy. Plast Reconstr Surg. 2007;119(2):556–61.

Asilian A, Darougheh A, Shariati F. New combination of triamcinolone, 5-Fluorouracil, and pulsed-dye laser for treatment of keloid and hypertrophic scars. Dermatol Surg. 2006;32(7):907–15.

Al-Khawajah MM. Failure of interferon-alpha 2b in the treatment of mature keloids. Int J Dermatol. 1996;35(7):515–7.

Krusche T, Worret WI. Mechanical properties of keloids in vivo during treatment with intralesional triamcinolone acetonide. Arch Dermatol Res. 1995;287(3–4):289–93.

Wong TW, Chiu HC, Yip KM. Intralesional interferon alpha-2b has no effect in the treatment of keloids. Br J Dermatol. 1994;130(5):683–5.

Pittet B, Rubbia-Brandt L, Desmoulière A, Sappino AP, Roggero P, Guerret S, et al. Effect of gamma-interferon on the clinical and biologic evolution of hypertrophic scars and Dupuytren's disease: an open pilot study. Plast Reconstr Surg. 1994;93(6):1224–35.

Layton AM, Yip J, Cunliffe WJ. A comparison of intralesional triamcinolone and cryosurgery in the treatment of acne keloids. Br J Dermatol. 1994;130(4):498–501.

Sproat JE, Dalcin A, Weitauer N, Roberts RS. Hypertrophic sternal scars: silicone gel sheet versus Kenalog injection treatment. Plast Reconstr Surg. 1992;90(6):988–92.

Larrabee Jr WF, East CA, Jaffe HS, Stephenson C, Peterson KE. Intralesional interferon gamma treatment for keloids and hypertrophic scars. Arch Otolaryngol Head Neck Surg. 1990;116(10):1159–62.

Granstein RD, Rook A, Flotte TJ, Haas A, Gallo RL, Jaffe HS, et al. A controlled trial of intralesional recombinant interferon-gamma in the treatment of keloidal scarring. Clinical and histologic findings. Arch Dermatol. 1990;126(10):1295–302.

Isaac C, Carvalho VF, Paggiaro AO, de Maio M, Ferreira MC. Intralesional pentoxifylline as an adjuvant treatment for perioral post-burn hypertrophic scars. Burns. 2010;36(6):831–5.

Lee RC, Doong H, Jellema AF. The response of burn scars to intralesional verapamil. Report of five cases. Arch Surg. 1994;129(1):107–11.

Ketchum LD, Smith J, Robinson DW, Masters FW. The treatment of hypertrophic scar, keloid and scar contracture by triamcinolone acetonide. Plast Reconstr Surg. 1966;38(3):209–18.

Patel N. Fat injection in severe burn outcomes: a new perspective of scar remodeling and reduction. Aesthetic Plast Surg. 2008;32(3):470–2.

Klinger M, Caviggioli F, Klinger FM, Giannasi S, Bandi V, Banzatti B, et al. Autologous fat graft in scar treatment. J Craniofac Surg. 2013;24(5):1610–5.

Balkin SW. Treatment of painful scars on soles and digits with injections of fluid silicone. J Dermatol Surg Oncol. 1977;3(6):612–4.

España A, Solano T, Quintanilla E. Bleomycin in the treatment of keloids and hypertrophic scars by multiple needle punctures. Dermatol Surg. 2001;27(1):23–7.

Griffith BH. The treatment of keloids with triamcinolone acetonide. Plast Reconstr Surg. 1966;38(3):202–8.

Aggarwal H, Saxena A, Lubana PS, Mathur RK, Jain DK. Treatment of keloids and hypertrophic scars using bleom. J Cosmet Dermatol. 2008;7(1):43–9.

Ahuja RB, Chatterjee P. Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids. Burns. 2014;40(4):583–8.

Gupta S, Kumar B. Intralesional cryosurgery using lumbar puncture and/or hypodermic needles for large, bulky, recalcitrant keloids. Int J Dermatol. 2001;40(5):349–53.

Kang N, Sivakumar B, Sanders R, Nduka C, Gault D. Intra-lesional injections of collagenase are ineffective in the treatment of keloid and hypertrophic scars. J Plast Reconstr Aesthet Surg. 2006;59(7):693–9.

Kiil J. Keloids treated with topical injections of triamcinolone acetonide (kenalog). Immediate and long-term results. Scand J Plast Reconstr Surg. 1977;11(2):169–72.

Kontochristopoulos G, Stefanaki C, Panagiotopoulos A, Stefanaki K, Argyrakos T, Petridis A, et al. Intralesional 5-fluorouracil in the treatment of keloids: an open clinical and histopathologic study. J Am Acad Dermatol. 2005;52(3 Pt 1):474–9.

Manuskiatti W, Fitzpatrick RE. Treatment response of keloidal and hypertrophic sternotomy scars: comparison among intralesional corticosteroid, 5-fluorouracil, and 585-nm flashlamp-pumped pulsed-dye laser treatments. Arch Dermatol. 2002;138(9):1149–55.

Margaret Shanthi FX, Ernest K, Dhanraj P. Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids. Indian J Dermatol Venereol Leprol. 2008;74(4):343–8.

Saray Y, Güleç AT. Treatment of keloids and hypertrophic scars with dermojet injections of bleomycin: a preliminary study. Int J Dermatol. 2005;44(9):777–84.

Baryza MJ, Baryza GA. The Vancouver Scar Scale: an administration tool and its interrater reliability. Burn Care Rehabil. 1995;16:535–8.

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