Wang Qimeng, Ren Zhesheng, Jin Wenyu, Jin Zhehu
Dermatology Department, Yanbian University Hospital, 1327 Juzi St, Yanji, 133002, Jilin, China.
Arch Dermatol Res. 2025 Jan 6;317(1):170. doi: 10.1007/s00403-024-03687-6.
Pathological scars are classified into hypertrophic scars and keloids, and currently have poor treatment outcomes and high recurrence rates. Bleomycin has received widespread attention in scar treatment in recent years, but there is currently no exploration on its real-world data. PubMed, Embase, and Cochrane databases were searched, and eight retrospective studies on the use of bleomycin for treatment were included, covering a total of 562 patients with keloids and hypertrophic scars. The meta-analysis results revealed that 90% of patients had significant flattening of scars after treatment with bleomycin, 5% had moderate flattening, and 4% had mild flattening. The recurrence rate after treatment was only 3%. The major adverse reaction was hyperpigmentation, with an incidence rate of 8%, and no significant ulcers or skin atrophy were reported. Subgroup analysis showed that the significant flattening rate treated with bleomycin alone was 91%, which was significantly different from the 79% treated with bleomycin in combined with triamcinolone acetonide, but the difference was not statistically significant. In addition, the significant flattening rate was 99% in Western patients and 57% in Asian patients, reflecting the impact of racial differences on treatment outcomes. There was no statistically significant difference in curative effects between males and females (RR: 0.95; P = 0.77). Overall, bleomycin has good curative effect in treating scars and has high safety, especially showing more significant effects in Western populations. However, racial differences, treatment plans, and other factors may affect the therapeutic effect of bleomycin. Future research can further explore the mechanisms of these factors and provide more personalized treatment plans for patients with scar.
病理性瘢痕分为增生性瘢痕和瘢痕疙瘩，目前治疗效果不佳且复发率高。近年来，博来霉素在瘢痕治疗中受到广泛关注，但目前尚无关于其真实世界数据的探索。检索了PubMed、Embase和Cochrane数据库，纳入了8项关于使用博来霉素治疗的回顾性研究，共涵盖562例瘢痕疙瘩和增生性瘢痕患者。荟萃分析结果显示，90%的患者在接受博来霉素治疗后瘢痕明显变平，5%的患者中度变平，4%的患者轻度变平。治疗后的复发率仅为3%。主要不良反应为色素沉着，发生率为8%，未报告明显溃疡或皮肤萎缩。亚组分析显示，单独使用博来霉素治疗的明显变平率为91%，与联合曲安奈德使用博来霉素治疗的79%有显著差异，但差异无统计学意义。此外，西方患者的明显变平率为99%，亚洲患者为57%，反映了种族差异对治疗效果的影响。男性和女性的疗效无统计学显著差异（RR：0.95；P = 0.77）。总体而言，博来霉素治疗瘢痕疗效良好且安全性高，尤其在西方人群中显示出更显著的效果。然而，种族差异、治疗方案等因素可能影响博来霉素的治疗效果。未来研究可进一步探索这些因素的机制，为瘢痕患者提供更个性化的治疗方案。
