Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Dermatol Ther. 2022 Sep;35(9):e15730. doi: 10.1111/dth.15730. Epub 2022 Aug 3.
Bleomycin is a known chemotherapeutic agent whose beneficial effects have been recently shown in the treatment of keloids and hypertrophic scars, however, it is unclear how effective it is in comparison with corticosteroids. We aimed to compare the safety and efficacy of intralesional bleomycin versus intralesional triamcinolone in the treatment of hypertrophic scars and keloids. Sixty patients were divided into two groups and treated by intralesional injection of triamcinolone (20 mg/ml) or bleomycin (1.5 mg/ml). The treatments were repeated every 3 weeks until the lesions flattened or for a maximum of six sessions. The clinical improvement was evaluated using the Japan scar workshop (JSW) scar scale (JSS) and the physician global assessment of flattening of the lesions. Side effects were also noted and recorded. 55 patients completed the study, 4 patients from the bleomycin group and 1 patient from the triamcinolone group dropped out of the study. In both groups, the total JSS scores decreased significantly after treatment compared to baseline (p < 0.001); however, the difference between groups was not statistically significant after treatment (p = 0.052). Moreover, the degree of flattening of the lesions was comparable between groups (p = 0.933). Side effects in the triamcinolone group were Hypopigmentation(55.2%), atrophy(51.7%), and telangiectasia(41.4%) and in bleomycin group included persistent pain after injection (61.5%), ulceration (69.2%), hyperpigmentation(76.9%), and secondary infection (34.6%). Intralesional bleomycin (1.5 mg/ml) is effective as triamcinolone(20 mg/ml) in the treatment of keloids and hypertrophic scars, however, bleomycin should be used carefully, due to adverse events such as pain, ulceration, and hyperpigmentation.
博来霉素是一种已知的化疗药物，其在治疗瘢痕疙瘩和增生性瘢痕方面的有益效果最近已得到证实，但与皮质类固醇相比，其疗效尚不清楚。我们旨在比较博来霉素和曲安奈德皮损内注射治疗增生性瘢痕和瘢痕疙瘩的安全性和疗效。60 名患者分为两组，分别接受曲安奈德（20mg/ml）或博来霉素（1.5mg/ml）皮损内注射治疗。每 3 周重复治疗，直至病变平坦或最多进行 6 次治疗。使用日本瘢痕工作坊（JSW）瘢痕量表（JSS）和医生对病变平坦度的总体评估来评估临床改善情况。还记录并记录了副作用。55 名患者完成了研究，博来霉素组有 4 名患者和曲安奈德组有 1 名患者退出了研究。在两组中，与基线相比，治疗后总 JSS 评分均显著降低（p<0.001）；然而，治疗后两组之间的差异无统计学意义（p=0.052）。此外，病变平坦度的程度在两组之间无差异（p=0.933）。曲安奈德组的副作用包括色素减退（55.2%）、萎缩（51.7%）和毛细血管扩张（41.4%），博来霉素组包括注射后持续性疼痛（61.5%）、溃疡（69.2%）、色素沉着过度（76.9%）和继发感染（34.6%）。博来霉素（1.5mg/ml）与曲安奈德（20mg/ml）一样有效治疗瘢痕疙瘩和增生性瘢痕，但由于疼痛、溃疡和色素沉着过度等不良反应，博来霉素应谨慎使用。
