Faculty of Medicine, Department of Dermatology and Andrology, Benha University, Benha, Egypt.
Dermatol Ther. 2020 Nov;33(6):e13980. doi: 10.1111/dth.13980. Epub 2020 Jul 27.
Keloids and hypertrophic scars could impair the psychological, physical, and cosmetic aspects of the patient's quality of life. Unfortunately, there is no curative treatment available till now. This study aimed to evaluate the efficacy and safety of intralesional vs topical botulinum toxin A combined with Fractional CO laser in the treatment of hypertrophic scars and keloids. Twenty patients with Keloids and hypertrophic scars were enrolled in the study. Each scar was divided into two halves, one subjected to intralesional injection of botulinum toxin type A once a month for 4 months and the other was subjected to four sessions of CO laser therapy at 1 month interval followed by topical application of botulinum toxin A. Significant improvement was noted in Vancouver Scar Scale in hypertrophic scars in laser group than intralesional botulinum toxin A. In keloid cases, the improvement was significantly higher with intralesional botulinum toxin A. Clinical improvement showed significant negative correlation with scar duration and size. Botulinum toxin A is a promising treatment for hypertrophic scars and keloids. The use of fractional CO laser as a mode of delivery enhanced the efficacy of botox in hypertrophic scars.
瘢痕疙瘩和增生性瘢痕会损害患者生活质量的心理、生理和美观方面。遗憾的是，目前尚无有效的治疗方法。本研究旨在评估皮损内注射与局部注射肉毒毒素 A 联合 Fractional CO2 激光治疗增生性瘢痕和瘢痕疙瘩的疗效和安全性。20 例瘢痕疙瘩和增生性瘢痕患者纳入本研究。每个瘢痕分为两部分，一部分每月接受肉毒毒素 A 皮损内注射一次，共 4 个月，另一部分接受 4 次 CO2 激光治疗，间隔 1 个月，然后局部应用肉毒毒素 A。激光组的温哥华瘢痕量表在增生性瘢痕中的评分显著改善，而皮损内注射肉毒毒素 A 对瘢痕疙瘩的改善明显更高。临床改善与瘢痕持续时间和大小呈显著负相关。肉毒毒素 A 是治疗增生性瘢痕和瘢痕疙瘩的一种很有前途的方法。使用 Fractional CO2 激光作为传递方式增强了肉毒毒素在增生性瘢痕中的疗效。
