The Treatment of keloids and hypertrophic scars with intralesional bleomycin in skin of color

doi:10.1111/jocd.12132

Paper

The Treatment of keloids and hypertrophic scars with intralesional bleomycin in skin of color

Published Mar 1, 2015 · K. Payapvipapong, N. Niumpradit, Chotinand Piriyanand

Journal of Cosmetic Dermatology

Q2 SJR score

66

Citations

3

Influential Citations

Full textSemantic Scholar

Abstract

Intralesional injection with corticosteroid remains the mainstay of therapy for hypertrophic scars and keloids, however some lesions are unresponsive or may result in skin atrophy. Intralesional bleomycin injection is an alternative therapy that has been widely reported. In order to compare the effectiveness and safety of bleomycin for the treatment of keloids and hypertrophic scars in skin of color population, Fitzpatrick skin type III to V patients with keloids or hypertrophic scars were randomized into two groups. Group A was treated monthly with intralesional triamcinolone acetonide (10 mg/mL), while group B with intralesional bleomycin (1 mg/mL) for three consecutive months. Evaluation of the treatment was performed using “Patient and Observer Scar Assessment Scale” (POSAS), self‐rated patient satisfaction score, photography, and ultrasonography. Two patients had their bleomycin blood levels monitored. Twenty‐six patients with keloids or hypertrophic scars were recruited. The clinical improvement as assessed by the POSAS was not statistically significant. In terms of patients satisfaction score, one half of both groups reported a very good improvement. Photographic as well as ultrasonographic evaluation showed no difference between the two groups. Bleomycin was found to enter the blood circulation in a very small amount. The major side effect was hyperpigmentation. There was no skin atrophy detected in this study. Intralesional bleomycin is a safe and effective treatment for keloids and hypertrophic scars. The treatment is comparable to intralesional triamcinolone. Unfortunately, hyperpigmentation was the major side effect in darker skin type.

RCT

Rigorous Journal

Study Snapshot

Key takeawayIntralesional bleomycin is a safe and effective treatment for keloids and hypertrophic scars in skin of color, but has a major side effect of hyperpigmentation in darker skin types.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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The Treatment of keloids and hypertrophic scars with intralesional bleomycin in skin of color

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References

Intralesional Treatment for Keloids and Hypertrophic Scars: A Review

Intralesional therapies for keloids and hypertrophic scars vary in mechanisms of action and side effect profiles, and new approaches are frequently explored.

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

A strategic approach involving structured assessment, targeted therapy, and prevention of recurrence is recommended for effectively managing keloid disease in ethnic skin.

Treatment of keloids and hypertrophic scars using bleomycin

Bleomycin is an effective and safe treatment for hypertrophic scars and keloids, with promising results in reducing scar size and improving skin texture.

Bleomycin Tattooing as a Promising Therapeutic Modality in Large Keloids and Hypertrophic Scars

Bleomycin tattoo may be more effective than cryotherapy combined with intralesional triamcinolon injection for treating larger keloids and hypertrophic scars (size>100 mm2).

The Patient and Observer Scar Assessment Scale: A Reliable and Feasible Tool for Scar Evaluation

The Patient and Observer Scar Assessment Scale is a reliable, consistent, feasible, and valid tool for evaluating scars, with patient opinions mainly influenced by itching and scar thickness.

Bleomycin in the Treatment of Keloids and Hypertrophic Scars by Multiple Needle Punctures

Bleomycin administration through multiple needle punctures shows promise in effectively treating keloids and hypertrophic scars, with potential for further investigation.

Inhibition of basal and TGF beta-induced fibroblast collagen synthesis by antineoplastic agents. Implications for wound healing.

Antineoplastic agents can inhibit collagen synthesis in fibroblasts, potentially impacting wound healing, but 5-fluorouracil is relatively harmless for intestinal healing.

Intralesional bleomycin sulfate therapy for warts. A novel bifurcated needle puncture technique.

Intralesional bleomycin sulfate therapy using a bifurcated vaccination needle effectively eliminates 92% of warts after a single treatment, with no recurrence observed during a 6-month follow-up.

Citations

A hospital-based single-arm study to assess the efficacy of intralesional bleomycin injection in patients of resistant periungual and palmoplantar warts

Intralesional bleomycin is a highly effective and safe treatment option for resistant periungual and palmoplantar warts, with mild-to-moderate side effects.

Safety and efficacy of intralesional bleomycin for keloids and hypertrophic scars: A systematic review and meta-analysis.

Bleomycin is more effective than TAC, 5-FU, or TAC combined with 5-FU for treating keloids and hypertrophic scars, with lower skin atrophy and telangiectasia risks, but may cause more pain.

A Comprehensive Review of Non-Surgical Treatments for Hypertrophic and Keloid Scars in Skin of Color

This review highlights the lack of effective treatments for hypertrophic and keloid scars in individuals with skin of color, emphasizing the need for individualized and multimodal therapeutic options.

The Efficacy of Bleomycin for Treating Keloid and Hypertrophic Scar

Bleomycin is a safe and effective method for treating keloids and hypertrophic scars, with the most common adverse effect being hyperpigmentation.

Comparison of the efficacy and safety of intralesional triamcinolone injection with the combination of triamcinolone, five fluorouracil, and hyluronidase enzyme in the treatment of keloids and hypertrophic scars

The combination of triamcinolone, five fluorouracil, and hyluronidase enzyme is more effective and safe than triamcinolone alone for treating keloids and hypertrophic scars, with faster response and acceptable aesthetic outcomes.