Tosa Mamiko, Ogawa Rei
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.
Scars Burn Heal. 2020 Jun 30;6:2059513120932059. doi: 10.1177/2059513120932059. eCollection 2020 Jan-Dec.
Keloid is a poorly understood disease that is unique to humans. Hypertrophic scars are similar to keloids and may transform into keloids over time. The standard treatments for these scars are limited by inconsistent efficacy and long treatment/follow-up times. Therefore, a new treatment that is effective for all abnormal scar cases is needed. One option may be photodynamic therapy (PDT). This review assesses the current evidence regarding the safety and efficacy of PDT for keloids and hypertrophic scars.
PubMed, Medline and Web of Science were searched from 1900 onwards for the following terms: 'keloid and photodynamic therapy (PDT)'; 'hypertrophic scar and photodynamic therapy (PDT)'; and 'scar and photodynamic therapy (PDT)'. Articles were included if they reported using topical PDT to treat keloids or hypertrophic scars, the patient(s) had one or more keloids and/or hypertrophic scars, and the effect of PDT on these abnormal scars was described.
In total, 538 articles were identified. Thirteen fulfilled all inclusion criteria. Eight were laboratory studies on keloid/hypertrophic scar explants, fibroblasts or tissue-engineered skin models and five were clinical studies/case reports. The clinical results of PDT on keloids and hypertrophic scars are encouraging.
PDT appears to play a promising role in keloid and hypertrophic scar therapy but additional clinical studies, particularly randomised clinical trials, are needed.
瘢痕疙瘩是一种人类特有的、了解甚少的疾病。增生性瘢痕与瘢痕疙瘩相似，且可能随时间转变为瘢痕疙瘩。这些瘢痕的标准治疗方法存在疗效不一致以及治疗/随访时间长的局限性。因此，需要一种对所有异常瘢痕病例均有效的新治疗方法。光动力疗法（PDT）可能是一种选择。本综述评估了关于PDT治疗瘢痕疙瘩和增生性瘢痕的安全性和疗效的现有证据。
检索了1900年起的PubMed、Medline和Web of Science，检索词如下：“瘢痕疙瘩和光动力疗法（PDT）”；“增生性瘢痕和光动力疗法（PDT）”；以及“瘢痕和光动力疗法（PDT）”。若文章报道使用局部PDT治疗瘢痕疙瘩或增生性瘢痕、患者有一个或多个瘢痕疙瘩和/或增生性瘢痕且描述了PDT对这些异常瘢痕的影响，则纳入该文章。
共识别出538篇文章。13篇符合所有纳入标准。8篇是关于瘢痕疙瘩/增生性瘢痕外植体、成纤维细胞或组织工程皮肤模型的实验室研究，5篇是临床研究/病例报告。PDT治疗瘢痕疙瘩和增生性瘢痕的临床结果令人鼓舞。
PDT在瘢痕疙瘩和增生性瘢痕治疗中似乎发挥着有前景的作用，但需要更多的临床研究，尤其是随机临床试验。
