Elradi Mona, Selim Heba, Hamed Dina E
All authors are affiliated with the Department of Dermatology, Venereology and Andrology, Zagazig University Hospitals, Zagazig, Egypt.
Dermatol Surg. 2025 Mar 4;51(6):593-598. doi: 10.1097/DSS.0000000000004566.
Keloids represent a troublesome condition that lacks a proper standard management protocol. Insulin and botulinum toxin A (BTX-A) both have evidence-based anti-scarring effects. Hence, their role in treating keloids needs to be investigated.
To compare insulin's efficacy versus BTX-A in treating keloids.
Sixty-three patients with keloids were randomly allocated into 3 equal groups. Group A was treated with intralesional insulin, Group B with intralesional BTX-A, and Group C with intralesional corticosteroids, each for 4 monthly sessions. The results were assessed objectively and subjectively using the patient and observer scar assessment scale.
All 3 groups showed a statistically significant reduction in volume before and after therapy, with percent changes of 66.6%, 25.3%, and 75% for Groups A, B, and C, respectively. Insulin and corticosteroids were statistically superior to BTX-A in improving pigmentation, reducing thickness, and inducing relief in treated keloids.
Both insulin and BTX-A show a promising role in managing keloids, with insulin demonstrating better efficacy. Botulinum toxin A is better recommended as an adjuvant therapy alongside other mainstay treatment modalities. Larger-scale studies are needed to confirm their roles and establish guidelines for their use.
瘢痕疙瘩是一种棘手的病症，缺乏合适的标准管理方案。胰岛素和肉毒杆菌毒素A（BTX-A）均有循证医学依据的抗瘢痕形成作用。因此，需要研究它们在治疗瘢痕疙瘩中的作用。
比较胰岛素与BTX-A治疗瘢痕疙瘩的疗效。
63例瘢痕疙瘩患者被随机分为3组，每组人数相等。A组采用病灶内注射胰岛素治疗，B组采用病灶内注射BTX-A治疗，C组采用病灶内注射皮质类固醇治疗，均每月治疗1次，共治疗4次。使用患者和观察者瘢痕评估量表对结果进行客观和主观评估。
所有3组在治疗前后体积均有统计学意义的减小，A组、B组和C组的体积变化百分比分别为66.6%、25.3%和75%。在改善色素沉着、减少厚度以及缓解治疗后的瘢痕疙瘩方面，胰岛素和皮质类固醇在统计学上优于BTX-A。
胰岛素和BTX-A在瘢痕疙瘩管理中均显示出有前景的作用，其中胰岛素疗效更佳。肉毒杆菌毒素A最好作为辅助治疗与其他主要治疗方式联合使用。需要开展更大规模的研究来证实它们的作用并制定使用指南。
