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Intralesional bleomycin versus intralesional triamcinolone in the treatment of keloids and hypertrophic scars

Dermatol Ther. 2022 Jul 24:e15730. doi: 10.1111/dth.15730. Online ahead of print.


Bleomycin is a known chemotherapeutic agent which its beneficial effects have been recently shown in the treatment of keloids and hypertrophic scars, however, it is unclear how effective it is in comparison with corticosteroids. To compare the safety and efficacy of intralesional bleomycin vs. intralesional triamcinolone in the treatment of hypertrophic scars and keloids. 60 patients were divided into two groups and treated by intralesional injection of triamcinolone (20 mg/mL) or bleomycin (1.5 IU/mL). The treatments were repeated every 3 weeks until the lesions flattened or for a maximum of 6 sessions. The clinical improvement was evaluated using the Japan Scar Workshop scar scale (JSS) and the physician global assessment of flattening of the lesions. Side effects were also noted and recorded 55 patients completed the study, 4 patients from the bleomycin group and 1 patient from the triamcinolone group dropped out of the study. In both groups, the total JSS scores decreased significantly after treatment compared to baseline (P < 0.001); however, the difference between groups was not statistically significant after treatment (P = 0.052). Moreover, the degree of flattening of the lesions was comparable between groups (p = 0.933). Side effects in the triamcinolone group were Hypopigmentation(55.2%), atrophy(51.7%), and telangiectasia(41.4%) and in bleomycin group included persistent pain after injection (61.5%) ulceration (69.2%), hyperpigmentation(76.9%), and secondary infection (34.6%). Intralesional bleomycin (1.5 IU/mL) is effective as triamcinolone(20 mg/mL) in the treatment of keloids and hypertrophic scars, however, bleomycin should be used carefully, due to adverse events such as pain, ulceration, and hyperpigmentation. This article is protected by copyright. All rights reserved.

PMID:35871490 | DOI:10.1111/dth.15730

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