2020, Number 3
<< Back Next >>
Cuba y Salud 2020; 15 (3)
Keloid Scars; review and experience in a comprehensive treatment
Tamayo CAM, Posada RDA, Orozco JMA, Cairos BJN, Florido SS
Language: Spanish
References: 45
Page: 90-97
PDF size: 899.34 Kb.
ABSTRACT
Objetivo: to provide updated knowledge of the pathophysiology
and comprehensive treatment of large keloid scars.
Development: health science descriptors DeCS-MESH
were constructed, searching in MEDLINE and EBSCO through
Pathological scar, Keloid Scar, Cicatrix, Granulation tissue using
AND boolean connector finding 24 articles accurately related to the
subject that were revised with their respective references using a total of 45 bibliographic references for the development. Keloids
are benign connective tissue neoplasms composed of dense
collagen masses. Its etiology is variable and the treatments are
directed to the removal of the affected tissue and control of the
fibroproliferative response. The accepted treatments vary from
medical management to surgical resection and the combination
of both.
Conclusions: treating keloid scars is a challenge for surgeons
given its high recurrence. Although therapeutic treatments are well
documented and widely known, it is necessary to use jointly and
successively multiple therapies such as surgery, drugs infiltration,
pressotherapy, among others to guarantee a better result.
REFERENCES
Barrera JA, Maan ZN, Gurtner GC. Adipose tissue in wound healing. En: Coleman SR, Marzola RF, Pu LLQ. Fat Inyection From Filling to Regeneration. 2 ed. New York: Thieme; 2018. p 179.
Lee Hj, Jang YJ. Recent understandings of Biology, Prophylaxis and treatment Strategies for Hypertrophic Scars and Keloids. International Journal of Molecular Sciences [Internet]. 2018 Mar [citado 3 May 2020];19(3):711. Disponible en: http://search.ebscohost.com/login.aspx?direc t=true&db=a9h&AN=128667861&lang=es&site=ehost-live
Beato Canfux AI, Valdés Mesa S, Machado Fernández ML, Palacios Alfonso IR. Cicatriz queloide gigante. Rev Cubana Med Militar [Internet]. 2020 [citado 3 May 2020]; 49(1):192-198. Disponible en: http://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=141693662&lang= es&site=ehost-live
Coiffman F. Cicatrices hipertrofias y queloides. En: Coiffman F, Vazques G. Cirugía Plástica. Reconstructiva y Estética. Tomo 1. 4ta ed. Colombia: AMOLCA; 2015. p.115-121.
Bijlard E, Kouwenberg CA, Timman R, Hovius SE, Busschbach JJ, Mureau MA. Burden of Keloid Disease: A Cross-sectional Health-related Quality of Life Assessment. Acta Derm Venereol. 2017 Feb;97(2):225-229. doi: 10.2340/00015555-2498.
He Y, Deng Z, Alghamdi M, Lu L, Fear MW, He L. From genetics to epigenetics: new insights into keloid scarring. Cell Prolif. [Internet]. 2017 Abr [citado 3 May 2020];50(2):[aprox. 12p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529126/ doi: 10.1111/cpr.12326.
Zhao B, Guan H, Liu JQ, Zheng Z, Zhou Q, Zhang J, et al. Hypoxia drives the transition of human dermal fibroblasts to a myofibroblast-like phenotype via the TGF-B1/Smad3 pathway. Int J Mol Med. 2017;39: 153-159. 10.3892/ijmm.2016.2816. 27909731
Ma X, Chen J, Xu B, Long X, Qin H, Zhao RC, et al. Keloid-derived keratinocytes acquire a fibroblast-like appearance and an enhanced invasive capacity in a hypoxic microenvironment in vitro. Int J Mol Med. 2015 May;35(5):1246-56. doi: 10.3892/ijmm.2015.2135.
Eun SH, Lee JH, Kim GM, Kim KH, Bae JM. Vitiligo at a Keloid scar: A possible case of Koebbner phenomenon. The Journal Of Dermatology [Internet]. 2019 Jan [cited 2020 Apr 4];46(1):e28-9. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=2992 3631&lang=es&site=ehost-live
da Silva IR, Tiveron LC, da Silva MV, Peixoto AB, Carneiro CAX, Dos Reis MA, et al. In Situ Cytokine Expression and Morphometric Evaluation of Total Collagen and Collagens Type I and Type III in Keloid Scars. Mediat. Inflamm. 2017; 2017: 6573802. doi:10.1155/2017/6573802.
Burgos IG. Queloides. Desde la fisiopatogenia a la terapéutica. Act Terap Dermatol.2006; 29: p.156-164.
Wang P, Jiang LZ, Xue B. Recombinant human endostatin reduces hypertrophic scar formation in rabbit ear model through down-regulation of VEGF and TIMP-1. Afr. Health Sci. 2016; 16: 542-553. 10.4314/ahs.v16i2.23. 27605970
Tuan TL, Nichter LS. The molecular basis of keloid and hypertrophic scar formation. Mol Med Today. 1998; 4: 19-24. 10.1016/S1357- 4310(97)80541-2.
Chua SC, Gidaszewski B, Khajehei M. Efficacy of surgical excision and sub-dermal injection of triamcinolone acetonide for treatment of keloid scars after caesarean section: a single blind randomised controlled trial protocol. Trials. 2019 Jun;20 (1):363. doi: 10.1186/s13063-019-3465-6.
Komenan K, Yves B, Alexander K, Kanga K, Ange A, Isidore K, et al. Keloid scars of the earlobe in young black African. Risks factors and care. Eur J Pediatr Dermatol [internet]. 2019 [citado 3 May 2020]; 29(4):206-208. Disponible en: http://search.ebscohost.com/login.aspx?direct=tru e&db=a9h&AN=141180281&Lang=es&site=ehost-live
Leventhal D, Furr M, Reiter D. Treatment of keloids and hypertrophic scars. A meta-analysis and review of the literature. Arch. Facial Plast. Sure. 2006; 8: 362-368. 10.1001/archfaci.8.6.362. 17116782
Ogawa R, Akaishi S, Huang C, Dohi T, Aoki M, Omori Y, Koike S, Kobe K, Akimoto M, Hyakusoku H. Clinical applications of basic research that shows reducing skin tension could prevent and treat abnormal scarring: The importance of fascial/subcutaneous tensile reduction sutures and flap surgery for keloid and hypertrophic scar reduction. J. Nippon Med. Sch. 2011; 78: 68-76. 101272/ jnms.7868. 21551962
Kasyanju Carrero LM, Ma WW, Liu HF, Yin XF, Zhou BR. Botulinum toxin type A for the treatment and prevention of hypertrophic scar and keloids: Updated review .J Cosmet Dermatol [Internet]. 2019 Feb [citado 3 May 2020]; 18(1):10-5. Disponible en: http://search.ebscohost.com/ login.aspx?direct=true&db=mdc&AN=30548742&lang=es&site=ehost-live
Bi M, Sun P, Li D, Dong Z, Chen Z. Intralesional injection of Botulinum Toxin Type A. Compared with intralesional Injection of Corticosteroid for the treatment of hypertrophic scar and keloid: A systematic review and Meta-Analysis. Med Sci J Exp clin res [internet]. 2019 Abr [citado 3 May 2020];25: 2950-8.Disponible en: http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=31006769&lang=es&site=ehost-live
Wong TS, Li JZ, Chen S, Chan JY, Gao W. The efficacy of triamcinolone Acetonide in Keloid Treatment: A sistematic review and Meta-analysis. Front. Med. 2016; 3: 71. 10.3389/fmed.2016.00071. 28083534
Mustoe TA. Evolution of silicone therapy and mechanism of action in scarmanagement. Aesthetic Plast Surg. 2008 Ene; 32(1): 82-92.
Dalkowski A, Fimmel S, Beutler C, Zouboulis CC. Cryotherapy modifies synthetic activity and differentiation of keloid fibroblasts in vitro. Exp Dermatol. 2003 Oct; 12(5):673-81.
Dawbwe R, Colver G, Jackson A, Cutaneous Criosurgery. Principles and Clinical Practice. (2nda edi). London. Martin Dunitz Ltd 1997: 54.
(24) Ogawa R. Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis. Int J Mol Sci [Internet]. 2017 [citado 3 May 2020];18(3):606. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372622/ 103390/ijms1800606.
Iturra GB. Queloides. Desde la fisiopatología a la terapéutica. Act Terap Dermatol 2006; 29: p.156
Cheraghi N, Cognetta A. Jr, Goldverg D. Radiation Therapy for the adjunctiveTreatment of surgically Excised Keloids: A review. J Clin Aesthet Dermatol. 2017; 10(8):12-15.
Ji. J, Tian Y, Zhu YQ, Zhang LY, Ji SJ, Huan J, Zhou XZ, Cao JP. Ionizing radiationinhibits keloid fibroblast cell proliferation and induces premature cellular senescence. J Dermatol. 2015; 42: 56-63. 10.1111/1346-8138.12702. 25425417
Calderon W, Camacho JP, Obaid RS, Vinés E. Manejo de queloides mediantecombinación de cirugía y radioterapia con haz de electrones. Cir Plasta Iberolatinoam. 2020; 46(1):57-64.
Hannuksela Svahn A, Grandal OJ, Thorstensen T. UVA 1 for treatment of keloids. Acta Derm. Venereol. 1999; 79: 496.
Garcia JM, Sebastian A, Rasgado TA, Bayat A. Optimization of an ex vivo wound healing model in the adult human skin: Functional evaluation using photodynamic therapy. Wound repair Regen. 2015;23(5):685-702.
Tanzi EL, Alster TS. Laser treatment of scars. Skin Ther. Lett. 2004; 9: 4-7.
Kim M, Kim SW, Kim H, Hwang CW, Choi JM, Kang HW. Development of a reproducible invivo laser-induced scar model for wound healing study and management. Biomed Opt Ex-press. 2019;10(4):1965-77.
Kafka M, Collins V, Kamolz LP, Rappl T, Branski LK, Wurzer P. Evidence of invasive and noninvasive treatment modalities for hypertrophic scars: A systematic review. Wound Repair and Regeneration: Official Publication Of The Wound Healing Society [And] The European Tissue Repair Society [internet]. 2017 Jan [cited 2020 Apr4;25(1):139-44. Available: http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=280 56485&lang=es&site=ehost-live
Espana A, Solano T, Quintanilla E. Bleomycin in the treatment of keloids andhypertrophic scars by multiple needle punctures. Dermatol. Surg. 2001; 27:23-27.11231236
Bodokh I, Brun P. Traitement des chéloides par infiltrations de bléomicine. AnnDermatol Venereol. 1996; 123: 791-794.
Gutierrez C, Quinto P, Andrade L, Alfaro HJ. Uso de la colchicina como adyuvante en el tratamiento de cicatrices queloides recidivantes. Reporte de un caso. Cir. Plást. 2001, 11(3): 126.
Peacock EE. Pharmacologic control of surface scarring in human beings. Ann. Surg. 1981, 193: 592.
Spring LK, Krakowski AC, Alam M, Bhatia A, Brauer J, Cohen J, et al. Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations. JAMA Dermatology [internet]. 2017 Aug 1 [cited 2020 Apr 4];153(8):802-9. Available from: http://search. ebscohost.com/login.aspx?direct=true&db=mdc&AN=28658462&lang=es&site=ehost-live
Phan TT, Lim IJ, Sun L, Chan SY, Bay BH, Tan EK, Lee ST. Quercitin inhibitsfibronectin production by keloid-derived fibroblasts. Implication for the treatment ofexcessive scars. J Dermatol Sci 2003; 33: 192-194. 10.1016/j.jdermsci.2003.08.008.14643528
Khawajah MM. Failure of interferon- a 2b in the treatment of mature keloids. Int J Dermal. 1996; 35: 515-517. 10.1111/j.1365-4362.1996. tb01671.x. 18211495
Shah M, Foreman DM, Ferguson MW. Neutralisation of TGFB1 and TGF B2 orexogenous addition of TGF B3 to cutaneous rat wounds reduces scarring. J Cell Sci.1885; 108Pt 3: 985-1002.
Jones ME, Hardy C, Ridgway J. Keloid Management: A Retrospective Case Review on a New Approach Using Surgical Excision, Platelet- Rich Plasma, and In-office Superficial Photon X-ray Radiation Therapy. Adv Skin Wound Care. 2016 Jul;29 (7): 303-7. doi: 10.1097/01. ASW.0000482993.64811.74
Li M, Qiu L, Hu W, Deng X, Xu H, Cao Y, et al. Genetically-modified bone mesenquimal stem cells with TGF-B3 improve wound healing and reduce scar tissue formation in a rabbit model. Exp Cell Res. 2018;367(1):24-9.
Uyulmaz S, Macedo NS, Rezaeian F, Giovanoli P, Lindenblatt N. Nanofat grafting for scar treatment and skin quality improvement. J. Aesth Surg. Cos Med. 2018; 38 (4): 421-428. DOI: 10.1093/asj/sjx183
Bruno A, Delli Santi G, Fasciani L, Cempanari M, Palombo M, Palombo P. Burn scarlipofilling: Immuno histochemical and clinical outcomes. J Craniofac Surg. 2013; 24:1806-1814. 10.1097/SCS.0b013e3182a148b9. 24036785