2011, Número 2
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Dermatología Cosmética, Médica y Quirúrgica 2011; 9 (2)
Cicatrización queloide: actualización de las opciones terapéuticas
Sánchez AK, Jesús SMA, Karam OM
Idioma: Español
Referencias bibliográficas: 98
Paginas: 111-121
Archivo PDF: 497.57 Kb.
RESUMEN
A pesar de los avances científicos, no existe ningún tratamiento
100% efectivo para las cicatrices queloides. Éstas representan
un reto no solo por la desfiguración cosmética, que en algunos
casos puede producir, sino también por dar síntomas que incomodan
al paciente como prurito y dolor.
Existe una amplia gama de opciones terapéuticas para las
cicatrices queloides, entre ellas las más comúnmente utilizadas
son: el corticosteroide intralesional (71%), la escisión quirúrgica
(50%), la crioterapia (64%), la terapia con láser (10%), la radioterapia
(70%), y la aplicación de parches de silicón (79-90%).
Otros tratamientos que han sido utilizados con tasas de éxito
variables son: el imiquimod y el interferón-α2b, así como 5-FU
(50%) y bloqueadores de canales de calcio (44%). De igual manera,
se han utilizado productos naturales como la vitamina E,
el extracto de cebolla, beta-sitosterol, centella asiática y
Bulbine
fructescens, pero éstos han tenido mayor efecto preventivo que
terapéutico. Algunos provocan reacciones secundarias, como
dermatitis de contacto. Es importante resaltar que la mayoría
de la evidencia para estas modalidades está basada en estudios
pequeños, que pocas veces emplean controles con placebo ni
tampoco son doble ciego. Por esta razón, es posible que tratamientos
actuales no tengan efectos significativos en la evolución
clínica. Basados en la información emergente sobre la
fisiopatología de las cicatrices queloides, han surgido nuevas y
prometedoras terapias moleculares, principalmente en relación
a la vía de activación del TGF-β. No obstante, por el momento
existe la necesidad de más ensayos clínicos con el fin de desarrollar
mejores terapias para la cicatrización patológica.
Se realiza este artículo con el fin de revisar las terapéuticas
existentes para la cicatrización queloide, así como las nuevas
opciones ahora en estudio.
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