Mamdouh Menna, Omar Ghada A, Hafiz Hala S A, Ali Sally M
Dermatology and Venereology, Al-Azhar University, Cairo, Egypt.
Radiodiagnosis Departments, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
J Cosmet Dermatol. 2022 Jan;21(1):331-336. doi: 10.1111/jocd.14070. Epub 2021 Mar 26.
Keloid is a benign well-demarcated overgrowth of fibrotic tissue which extends beyond the original boundaries of a defect. The treatment of keloids is a particular challenge to dermatologists. Intralesional corticosteroid injection has been considered the first-line treatment for keloids. Vitamin D plays an important role in cell proliferation and differentiation as it slows the progression of tissue fibrosis by keloid fibroblasts and inhibits collagen synthesis in dermal fibrosis.
To evaluate the efficacy of intralesional injection of vitamin D in the treatment of keloids, both clinically and ultrasonically.
Forty Egyptian patients with keloid scars were injected weekly with intralesional vitamin D with dose of 0.2 ml (200,000 IU) per 1 cm lesion. The keloid scars were evaluated with Vancouver Scar Scale (VSS) and by a high-resolution ultrasound using B mode before and after treatment, the patients received 3 to 4 sessions.
There was statistically highly significant reduction in VSS after treatment with intralesional vitamin D injection (p value≤0.001). There was also statistically highly significant improvement in ultrasonic keloid scar thickness after treatment (P value ≤0.001).
Intralesional vitamin D is an effective and safe method in treatment of keloid scars. Ultrasound is a useful method in assessing the improvement of keloids after treatment.
瘢痕疙瘩是一种良性的、界限清晰的纤维化组织过度生长,其超出了缺损的原始边界。瘢痕疙瘩的治疗对皮肤科医生来说是一项特殊挑战。病灶内注射皮质类固醇一直被认为是瘢痕疙瘩的一线治疗方法。维生素D在细胞增殖和分化中起重要作用,因为它可减缓瘢痕疙瘩成纤维细胞导致的组织纤维化进程,并抑制真皮纤维化中的胶原蛋白合成。
从临床和超声方面评估病灶内注射维生素D治疗瘢痕疙瘩的疗效。
40例埃及瘢痕疙瘩患者每周接受病灶内注射维生素D,每1厘米病灶注射剂量为0.2毫升(200,000国际单位)。在治疗前后,使用温哥华瘢痕量表(VSS)和B型高分辨率超声对瘢痕疙瘩进行评估,患者接受3至4个疗程。
病灶内注射维生素D治疗后,VSS有统计学意义的显著降低(p值≤0.001)。治疗后瘢痕疙瘩超声厚度也有统计学意义的显著改善(P值≤0.001)。
病灶内注射维生素D是治疗瘢痕疙瘩的一种有效且安全的方法。超声是评估治疗后瘢痕疙瘩改善情况的一种有用方法。