Pharmacologic control of surface scarring in human beings.

A hypothetical basis for control of surface scar in human beings is: lathyrism produces poorly cross-linked collagen in healing wounds; poorly corss-linked collagen is more susceptible to digestion by tissue collagenase than is normally cross-linked collagen; and colchicine stimulates tissue collagenase activity. Therefore, treatment of patients with abnormal deposits of surface scar by excising the scar, inducing lathyrism, and administering colchicine should tend to correct abnormal balance between collagen synthesis and collagenolysis and result in a small scar with improved physical properties. Ten patients with massive keloids, resistant to conventional therapy by excision, grafting, and/or intralesional injection of steroids, have been treated by excising the keloid, grafting the defect, inducing lathyrism with Beta aminopropionitrile fumurate or penicillamine and administering colchicine. Patients were followed for 18 months to five years. No toxicity or untoward side effects from therapy were observed. No patients developed recurrent keloids while undergoing treatment. All patients showed some change in the amount of scar which persisted during the period of study. This data supports the hypothesis that lathyrism and colchicine therapy exert a measurable beneficial effect on surface scar in human beings.