Assuntos
Corticosteroides/administração & dosagem , Linfócitos T CD4-Positivos , Interleucinas/administração & dosagem , Linfoma Cutâneo de Células T/tratamento farmacológico , Transtornos Linfoproliferativos/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Feminino , Humanos , Injeções Intralesionais/métodos , Linfoma Cutâneo de Células T/complicações , Linfoma Cutâneo de Células T/diagnóstico , Transtornos Linfoproliferativos/complicações , Transtornos Linfoproliferativos/diagnóstico , Nariz/efeitos dos fármacos , Nariz/patologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnósticoRESUMO
BACKGROUND: Earlobe keloids are usually recalcitrant to treatment and have a high rate of recurrence. Verapamil is a calcium channel antagonist that has been shown to inhibit the synthesis/secretion of extracellular matrix molecules and increase collagenase. OBJECTIVES: This prospective study was designed to evaluate the results of treatment of recurrent earlobe keloids using keloidectomy with core fillet flap and intralesional verapamil injection. METHODS: Nineteen keloids in 16 patients were treated using this technique with intralesional verapamil injection given intraoperatively, then every 2 weeks for 3 months, with postoperative follow-up for 18 months. RESULTS: Fourteen patients completed the study. Ten patients (71.4%) showed response to treatment. Four (28.6%) cases showed recurrence, two (14.2%) at the wound bed and another two (14. 2%) at the incision line. Eighty percent of responders were highly satisfied with their treatment. CONCLUSION: Keloidectomy with core fillet flap and intralesional verapamil injection is a reliable and cost-effective method in the treatment of recurrent earlobe keloids with a low rate of recurrence and high patient satisfaction.
Assuntos
Pavilhão Auricular/efeitos dos fármacos , Pavilhão Auricular/cirurgia , Injeções Intralesionais/métodos , Queloide/tratamento farmacológico , Queloide/cirurgia , Verapamil/administração & dosagem , Adolescente , Adulto , Bloqueadores dos Canais de Cálcio/administração & dosagem , Pavilhão Auricular/patologia , Feminino , Seguimentos , Humanos , Queloide/diagnóstico , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
BACKGROUND: Hypertrophic scars are dermal fibroproliferative disorders that typically develop after a skin injury heals. They can cause physical, psychological, and cosmetic problems. The management of such scars remains a matter of debate due to lack of effective treatment methods and the inability to prevent recurrences. Recent reports have demonstrated that botulinum toxin type A improves wound healing so it may play a role in treating hypertrophic scars. AIMS: We assessed the effectiveness of intralesional botulinum toxin type A injection for treating hypertrophic scars. METHODS: This prospective clinical study included twenty patients with hypertrophic scars. Intralesional injection of botulinum toxin type A was given once a month for three months with a follow-up period of six months. Each lesion was injected until slight blanching occurred. Therapeutic satisfaction of the patient and physician were recorded. Lesions were assessed for erythema, itching and pliability. Each item was assessed on a 5-point scale. RESULTS: Therapeutic satisfaction was recorded as 'good' in 14 patients and 'excellent' in the remaining six. The mean erythema score decreased from 3.2 to 1.0, the mean pliability score from 3.3 to 0.8 and the mean itching score from 2.7 to 0.7. All of these were statistically significant. LIMITATIONS: A larger sample size and longer follow-up period would have given a better evaluation but was not feasible due to the high expenses involved. CONCLUSION: Botulinum toxin type A is a novel and promising therapy for hypertrophic scars with few side effects.