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维生素D注射对瘢痕疙瘩和增生性瘢痕的影响。

Impact of Vitamin D Injection on Keloids and Hypertrophic Scars.

作者信息

Hassan Amel R, Binsaleh Ammena Y, El-Tahlawi Samar M, El-Amir Azza M, Ishak Mary M, Alsubaie Nawal, El-Masry Thanaa A, Bahaa Mostafa M, Eldesoqui Mamdouh, Kamal Marwa

机构信息

Department of Dermatology, STDs and Andrology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.

Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

出版信息

J Cosmet Dermatol. 2025 Apr;24(4):e70118. doi: 10.1111/jocd.70118.

Abstract

BACKGROUND

Hypertrophic scars and keloids are human cutaneous fibroproliferative conditions that develop after burns, trauma, surgery, and inflammation. Vitamin D inhibits keloid fibroblast proliferation by reducing TGF-β-induced extracellular matrix formation, boosting matrix metalloproteinase activity, and reducing inflammation.

AIM

To study the effect of intralesional and systemic Vitamin D3 injection on hypertrophic scars and keloids and whether vitamin D3 deficiency increases scarring.

PATIENTS AND METHODS

This study included 30 hypertrophic scars and keloid patients divided into groups depending on serum vitamin D levels. Every patient was tested for vitamin D using ELISA. Group I: patients with vitamin D deficiency or insufficiency received a systemic injection of vitamin D (cholecalciferol 200 000 I.U.) once monthly for 3 months with a calcium oral supplement and intralesional vitamin D injections on hypertrophic scars and keloids. Group II: patients with sufficient vitamin D received only intralesional vitamin D injections.

RESULTS

Vitamin D deficiency did not affect scar formation or severity (total Vancouver scar scale before assessment) with a p value > 0.05. All instances showed a substantial drop in vascularity, pliability, and total Vancouver scale score (p value < 0.05) following intervention, but no change in scar pigmentation or height. Scar assessment following intervention did not significantly differ between research groups (p > 0.05).

CONCLUSION

Injection of vitamin on hypertrophic scars and keloids enhances vascularity and pliability in patients with sufficient serum vitamin D levels and those with deficient or insufficient serum vitamin D levels after improving them by systemic injection of vitamin D without any effect on height and pigmentation of scars.

TRIAL REGISTRATION

NCT06301178.

摘要

背景

增生性瘢痕和瘢痕疙瘩是人类皮肤纤维增生性疾病,在烧伤、创伤、手术和炎症后形成。维生素D通过减少转化生长因子-β诱导的细胞外基质形成、增强基质金属蛋白酶活性和减轻炎症来抑制瘢痕疙瘩成纤维细胞增殖。

目的

研究病灶内和全身注射维生素D3对增生性瘢痕和瘢痕疙瘩的影响,以及维生素D3缺乏是否会增加瘢痕形成。

患者和方法

本研究纳入30例增生性瘢痕和瘢痕疙瘩患者,根据血清维生素D水平分组。每位患者均采用酶联免疫吸附测定法检测维生素D。第一组:维生素D缺乏或不足的患者每月接受一次维生素D(胆钙化醇200000国际单位)全身注射,共3个月,并口服钙补充剂,同时对增生性瘢痕和瘢痕疙瘩进行病灶内维生素D注射。第二组:维生素D充足的患者仅接受病灶内维生素D注射。

结果

维生素D缺乏对瘢痕形成或严重程度(评估前的温哥华瘢痕总评分)无影响,p值>0.05。所有病例在干预后血管化、柔韧性和温哥华总评分均显著下降(p值<0.05),但瘢痕色素沉着或高度无变化。干预后的瘢痕评估在研究组之间无显著差异(p>0.05)。

结论

对增生性瘢痕和瘢痕疙瘩注射维生素,可使血清维生素D水平充足的患者以及通过全身注射维生素D改善血清维生素D缺乏或不足的患者的血管化和柔韧性增强,且对瘢痕的高度和色素沉着无任何影响。

试验注册

NCT06301178。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c489/11938404/1577092511fb/JOCD-24-e70118-g001.jpg

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