Pereira Carlos Augusto Zanardini, Alchorne Alice de Oliveira de A
Dermatology Service, Hospital Santa Casa de Curitiba, Pontifícia Universidade Católica do Paraná, Brazil.
BMC Dermatol. 2010 Aug 24;10:7. doi: 10.1186/1471-5945-10-7.
Topical phenytoin is a powerful skin wounds healing and it may be useful in clinical practice. The purpose of this study was to evaluate the effect of topical phenytoin 0.5%, by comparing it with cream (control) in wounds resulting from excision of two melanocytic nevi in the same patient. Our purpose was also to assess if phenytoin had better therapeutic and cosmetic outcomes when compared with cream (control).
This study evaluated 100 patients with skin wounds from excision of melanocytic nevi. 50 patients with lesions on the face and 50 patients with lesions on the back, totalizing 200 lesions excised with modified punch. The resulting superficial skin wounds had the same diameter and depth, and second intention healing followed.Patients were followed for 60 days. Student's t-test, Mann Whitney nonparametric test, analysis of variance, LSD test, Shapiro-Wilks test and Fisher test were used to analyze the results, depending on the nature of the variables being studied.
Phenytoin showed better therapeutic and cosmetic results, by healing faster, with more intense epithelization in wounds in comparison with cream (control). Phenytoin showed a statistically significant difference regarding the following parameters (p < 0.05): wounded area and healing time. Phenytoin application resulted in a smaller area and a shorter healing time. Also the intensity of exudates, bleeding, and the epithelization were more intense in phenytoin-treated wounds. Regarding the shape and thickness of the scar, injuries treated with phenytoin had round and flat shaped scars in most of the cases. Considering patient's gender and phototype, female patients presented smaller wounds and scar areas; and phototype I had the largest scar areas. Contact eczema was an adverse reaction in 7 injuries located on the back caused by cream (control) and hypoallergenic tape.
Phenytoin showed better therapeutic and cosmetic results compared with cream (control). Phenytoin is a low cost drug, which accelerates skin wounds healing in human patients.
ISRCTN96539803.
局部应用苯妥英钠对皮肤伤口愈合有显著作用，可能在临床实践中具有应用价值。本研究旨在通过比较同一患者切除两个黑素细胞痣后伤口局部应用0.5%苯妥英钠与乳膏（对照）的效果，评估其疗效。我们的目的还包括评估与乳膏（对照）相比，苯妥英钠是否具有更好的治疗和美容效果。
本研究评估了100例因切除黑素细胞痣而导致皮肤伤口的患者。其中50例患者的皮损位于面部，50例患者的皮损位于背部，总共用改良打孔器切除200个皮损。由此产生的浅表皮肤伤口具有相同的直径和深度，并采用二期愈合。对患者进行60天的随访。根据所研究变量的性质，使用学生t检验、曼-惠特尼非参数检验、方差分析、LSD检验、夏皮罗-威尔克检验和费舍尔检验来分析结果。
与乳膏（对照）相比，苯妥英钠显示出更好的治疗和美容效果，伤口愈合更快，上皮化更明显。苯妥英钠在以下参数方面显示出统计学上的显著差异（p < 0.05）：伤口面积和愈合时间。应用苯妥英钠导致伤口面积更小，愈合时间更短。此外，苯妥英钠治疗的伤口渗出物、出血强度和上皮化程度也更明显。关于瘢痕的形状和厚度，苯妥英钠治疗的伤口在大多数情况下有圆形和平坦的瘢痕。考虑患者的性别和皮肤类型，女性患者的伤口和瘢痕面积较小；皮肤类型I的瘢痕面积最大。接触性湿疹是背部7例由乳膏（对照）和低敏胶带引起的损伤的不良反应。
与乳膏（对照）相比，苯妥英钠显示出更好的治疗和美容效果。苯妥英钠是一种低成本药物，可加速人类患者皮肤伤口的愈合。
ISRCTN96539803。
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