Dermatology Service, Veterans Affairs New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, NY, USA.
New York Medical College, Valhalla, NY, USA.
Arch Dermatol Res. 2024 Aug 23;316(8):560. doi: 10.1007/s00403-024-03277-6.
Keloids, characterized by excessive scar formation following dermal inflammation, pose a therapeutic challenge due to high recurrence rates. Radiation therapy, contraindicated in children, can minimize recurrence post-surgical removal. Dupilumab, which inhibits the pro-fibrotic interleukin-4/interleukin-13 axis, may effectively manage keloids when intralesional corticosteroid injections are unsuccessful. It may also prevent recurrence post-surgery in pediatric patients. This systematic review assesses the efficacy and safety of dupilumab for the treatment of keloids. Through a systematic search adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified and analyzed outcomes from three case reports and three case series studies, totaling 15 patients. Results indicate variable responses to treatment, including significant improvements, no clinical change, and worsening of keloid symptoms. Additional research is needed to recommend using dupilumab to treat keloids (Grade D). Treatment response variability may be linked to differences in interleukin-4/interleukin-13 activity between active and inactive keloids. Additionally, the unintended promotion of T helper 17 cell differentiation by dupilumab may worsen keloids.
瘢痕疙瘩是一种皮肤炎症后过度形成瘢痕的疾病，由于复发率高，治疗具有挑战性。放射治疗不适用于儿童，可在手术后切除后最大限度地减少复发。当局部皮质类固醇注射无效时，抑制致纤维化白细胞介素-4/白细胞介素-13 轴的度普利尤单抗可能有效地治疗瘢痕疙瘩。它也可能预防小儿患者手术后的复发。本系统评价评估了度普利尤单抗治疗瘢痕疙瘩的疗效和安全性。通过遵循系统评价和荟萃分析的首选报告项目进行系统搜索，我们确定并分析了来自 3 份病例报告和 3 份病例系列研究的结果，共有 15 名患者。结果表明，治疗反应存在差异，包括显著改善、无临床变化和瘢痕疙瘩症状恶化。需要进一步研究来推荐使用度普利尤单抗治疗瘢痕疙瘩（D 级）。治疗反应的可变性可能与活性和非活性瘢痕疙瘩中白细胞介素-4/白细胞介素-13 活性的差异有关。此外，度普利尤单抗意外促进 T 辅助 17 细胞分化可能会使瘢痕疙瘩恶化。
