Sheng Meiying, Chen Yunsheng, Li Hua, Zhang Yixin, Zhang Zheng
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Rd, Shanghai 200011, P.R. China.
Department of Burns and Plastic Surgery, Shanghai Institute of Burns Research, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China.
Burns Trauma. 2023 Mar 18;11:tkad009. doi: 10.1093/burnst/tkad009. eCollection 2023.
The prevention and treatment of pathological scars remain challenging. Corticosteroids are the mainstay drugs in clinical scar prevention and treatment as they effectively induce scar regression and improve scar pruritus and pain. Currently, intralesional injections of corticosteroids are widely used in clinical practice. These require professional medical manipulation; however, the significant accompanying injection pain, repetition of injections and adverse effects, such as skin atrophy, skin pigmentation and telangiectasia, make this treatment modality an unpleasant experience for patients. Transdermal administration is, therefore, a promising non-invasive and easy-to-use method for corticosteroid administration for scar treatment. In this review, we first summarize the mechanisms of action of corticosteroids in scar prevention and treatment; then, we discuss current developments in intralesional injections and the progress of transdermal delivery systems of corticosteroids, as well as their corresponding advantages and disadvantages.
病理性瘢痕的防治仍然具有挑战性。皮质类固醇是临床瘢痕防治的主要药物,因为它们能有效促使瘢痕消退,并改善瘢痕瘙痒和疼痛。目前,皮质类固醇皮损内注射在临床实践中广泛应用。这些操作需要专业的医学手法;然而,随之而来的显著注射疼痛、多次注射以及诸如皮肤萎缩、皮肤色素沉着和毛细血管扩张等不良反应,让这种治疗方式给患者带来不愉快的体验。因此,经皮给药是一种很有前景的皮质类固醇给药方式,用于瘢痕治疗,具有非侵入性且易于使用的特点。在本综述中,我们首先总结皮质类固醇在瘢痕防治中的作用机制;然后,我们讨论皮损内注射的当前进展以及皮质类固醇经皮给药系统的进展,以及它们相应的优缺点。