Brandão Marina Patrus Ananias de Souza, Vieira Carolina Fernandes Otoni, Rocha Daniel Brasil Braga, Silva Márcio Roberto, da Silva Jussara Aparecida, Gold Michael H, de Oliveira Gisele Viana
Post Graduation Department, Medical Sciences Faculty of Minas Gerais (FCMMG), Belo Horizonte, Brazil.
EMBRAPA Gado de Leite, Juiz de Fora, Brazil.
Int J Dermatol. 2025 Aug;64(8):1434-1440. doi: 10.1111/ijd.17829. Epub 2025 May 5.
Keloid treatment remains challenging due to high recurrence rates, particularly in patients with higher phototypes. This study aimed to assess the resolution, patient satisfaction, and recurrence rates in 79 keloids treated with a sequential non-surgical protocol combining long-term occlusion with hydrocolloid dressings, monthly injections of triamcinolone and 5-fluorouracil (5-FU), and intense pulsed light therapy. This approach is expected to lower recurrence, improve resolution, and increase patient satisfaction compared to traditional treatments.
This longitudinal observational study included 79 keloids in 55 patients with Fitzpatrick phototypes III or higher. Data were collected retrospectively from medical records and clinical appointments. Patients were followed for 19-123 months after completing treatment. Outcomes evaluated included keloid resolution, patient satisfaction, and recurrence rates.
The patients had a mean age of 39 years and underwent treatment for a median of 10 months. Pain was reported in 8.9% of cases, and only one recurrence (1.3%) occurred five years post-treatment. Complete resolution was achieved in 82.3% of keloids, and 94.9% of patients reported maximum satisfaction.
The sequential non-surgical approach evaluated in this study demonstrated low recurrence and high satisfaction rates. Thus, it may represent a promising treatment option for keloid patients with higher phototypes.
由于瘢痕疙瘩复发率高，尤其是在皮肤光类型较高的患者中，瘢痕疙瘩的治疗仍然具有挑战性。本研究旨在评估79例瘢痕疙瘩采用序贯非手术方案治疗后的消退情况、患者满意度和复发率，该方案包括长期使用水胶体敷料封闭、每月注射曲安奈德和5-氟尿嘧啶（5-FU）以及强脉冲光治疗。与传统治疗相比，这种方法有望降低复发率、提高消退率并提高患者满意度。
这项纵向观察性研究纳入了55例皮肤光类型为III型或更高的患者的79个瘢痕疙瘩。数据通过回顾病历和临床预约进行收集。患者在完成治疗后随访19 - 123个月。评估的结果包括瘢痕疙瘩的消退情况、患者满意度和复发率。
患者的平均年龄为39岁，治疗时间中位数为10个月。8.9%的病例报告有疼痛，治疗后五年仅发生1例复发（1.3%）。82.3%的瘢痕疙瘩实现了完全消退，94.9%的患者表示非常满意。
本研究评估的序贯非手术方法显示出低复发率和高满意率。因此，它可能是皮肤光类型较高的瘢痕疙瘩患者的一种有前景的治疗选择。
