Application of topical mitomycin C to the base of shave-removed keloid scars to prevent their recurrence.

ABSTRACT

BACKGROUND: Keloid scars are formed by over-activity of fibroblasts producing collagen and they cause significant morbidity both from their appearance and from their symptoms. Existing treatments are often unsatisfactory. Topical mitomycin C is known to inhibit fibroblast proliferation. OBJECTIVES: To determine whether application of mitomycin C to the base of shave-removed keloids would prevent their recurrence. METHODS: Ten patients had all or part of their keloid shave-removed. After haemostasis topical mitomycin C 1 mg mL(-1) was applied for 3 min. This application was repeated after 3 weeks. The keloids were photographed before treatment and the patients were reviewed every 2 months for a total of 6 months when a final photograph of the keloid site was taken. The patients and the Clinical Trials Unit staff scored the outcome on a linear analogue scale of 0-10, where 0 = disappointed and 10 = delighted. The pretreatment and 6-month post-treatment photographs were also assessed by two dermatologists who were not involved in the clinical trial. RESULTS: Four of the 10 patients were delighted with the outcome of treatment and only one was disappointed. On average there was an 80% satisfied outcome. CONCLUSIONS: This new treatment of keloids has been shown to be effective in the majority of patients but further studies are required to confirm this benefit.