Lu Ziyue, Zhu Ding, Yang Yunchuan, Kou Huiling, Li Xinying, Zhang Junbo
International Medical College, Chongqing Medical University, Chongqing 400046, PR China.
Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Medical University, Chongqing 400042, PR China.
Photodiagnosis Photodyn Ther. 2024 Dec;50:104335. doi: 10.1016/j.pdpdt.2024.104335. Epub 2024 Sep 12.
Auricular keloids are a significant clinical challenge, which adversely affect the life of the patient at the level of aesthetic and psychological well-being. Despite various treatment modalities, a universally effective therapy has yet to be established. Photodynamic therapy (PDT) offers a promising approach by inhibiting the abnormal proliferation of fibroblasts while minimizing damage to surrounding healthy cells and tissues. This study evaluates the clinical outcomes of auricular keloid patients treated with excision followed by 5-aminolevulinic acid photodynamic therapy (ALA-PDT).
This study included 8 patients diagnosed with auricular keloids based on pathological examination and clinical presentation. Following surgical excision of the auricular keloids, topical 5-ALA solution was applied for 4 h. Then each lesion was irradiated with 120 J/cm² using a red LED (635-nm laser) for 20 min. Patients received 3-5 courses of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) during and after the surgery.
Among the 8 patients treated, auricular keloids were completely controlled with the combination therapy. During a follow-up period of 2.7 years (range: 1.8-4.1 years), all patients exhibited excellent outcomes with no recurrence of keloids.
The combination of surgical excision and 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is an effective and safe treatment for auricular keloids. This combined approach shows promise as an alternative clinical treatment for managing auricular keloids.
耳部瘢痕疙瘩是一个重大的临床挑战，在美学和心理健康层面会对患者生活产生不利影响。尽管有多种治疗方式，但尚未确立一种普遍有效的疗法。光动力疗法（PDT）通过抑制成纤维细胞的异常增殖，同时将对周围健康细胞和组织的损伤降至最低，提供了一种有前景的方法。本研究评估了耳部瘢痕疙瘩患者接受切除后再进行5-氨基酮戊酸光动力疗法（ALA-PDT）的临床效果。
本研究纳入了8例根据病理检查和临床表现诊断为耳部瘢痕疙瘩的患者。在手术切除耳部瘢痕疙瘩后，局部应用5-ALA溶液4小时。然后使用红色发光二极管（635纳米激光）以120 J/cm²的剂量对每个病变照射20分钟。患者在手术期间及术后接受3-5个疗程的5-氨基酮戊酸光动力疗法（ALA-PDT）。
在接受治疗的8例患者中，联合治疗完全控制了耳部瘢痕疙瘩。在2.7年（范围：1.8-4.1年）的随访期内，所有患者均取得了良好效果，瘢痕疙瘩无复发。
手术切除与5-氨基酮戊酸光动力疗法（ALA-PDT）联合应用是治疗耳部瘢痕疙瘩的一种有效且安全的方法。这种联合方法有望成为治疗耳部瘢痕疙瘩的一种替代临床治疗手段。
