Recurrence of keloids after application of epidermal growth factor
DOI:
https://doi.org/10.18203/2349-2902.isj20194076Keywords:
Keloid, Excision, Epidermal growth factor, Recurrence ratesAbstract
Background: Exact aetiology for keloid formation is yet unknown. The prime goal of the therapy is to decrease the process of scarring. Many modalities of treatment are available for keloids. With current treatment modalities, recurrence rates approaches 75%. This study was conducted to find out whether application of Epidermal growth factor will reduce recurrence rates of keloids, after surgical excision.
Methods: An observational study was conducted by collecting details of 40 patients who underwent surgical excision of keloids followed by epidermal growth factor application over the wounds. The patients have been followed up to 6th months post excision and recurrence rates of keloids as well as overall scar quality were analysed.
Results: Out of 45 patients included in the study, 16 (35.6 %) were males and rest females. The median age of the study population was 18.0 (with an IQR 16.0; 26.0). Out of 45 patients, 12 patients had family history of keloids (73%). Out of 45 patients, 8 had keloid tendency which amounts to 82%. Out of 45 patient who underwent treatment, 22 patient developed recurrence which is 48.9% Out of 45 patients included in the study, 16 (35.6 %) were males and rest females. The median age of the study population was 18.0 (with an IQR 16.0; 26.0). Out of 45 patients, 12 patients had family history of keloids (73%). Out of 45 patients, 8 had keloid tendency which amounts to 82%. Out of 45 patient who underwent treatment, 22 patient developed recurrence which is 48.9%.
Conclusions: There is a dearth of randomized controlled trials supporting the efficacy of epidermal Growth factor in preventing keloid recurrence. The subjective improvements seen in some cases are encouraging. This study will be a foundation for future studies and will highlight the breadth of knowledge yet to be explored by this therapy.
References
Layton AM, Yip J, Cunliffe WJ. A comparison of intralesional triamcinolone and cryosurgery in the treatment of acne keloids. Br J Dermatol. 1994;130:498–501.
Rusciani L, Paradisi A, Alfano C. Cryotherapy in the treatment of keloids. J Drugs Dermatol. 2006;5:591–5.
Alster TS, Williams CM. Treatment of keloid sternotomy scars with 585 nm flashlamp-pumped pulsed-dye laser. Lancet. 1995;345:1198–200.
Mustoe TA, Cooter RD, Gold MH, Hobbs FD, Ramelet AA, Shakespeare PG, et al. International clinical recommendations on scar management. Plast Reconstr Surg. 2002;110:560–71.
Greenhalgh D. The role of growth factors in wound healing. J Trauma 1996;41:159-67.
Throne CH. Grabb and smith plastic surgery. Seventh edition. Philadelphia: Lippincott William & Wilkins; 2014: 2-16.
Satish L, Babu M, Tran KT, Hebda PA, Wells A. Keloid fibroblast responsiveness to epidermal growth factor and activation of downstream intracellular signaling pathways. Wound Repair Regen. 2004;12(2):183-92.
Esquirol Caussa J, Herrero Vila E. Epidermal growth factor, innovation and safety. Med Clin (Barc). 2015;145(7):305-12.
Al-Attar A, Mess S, Thomassen JM, Kauffman CL, Davison SP. Keloid pathogenesis and Treatment. Plast Reconstr Surg. 2006;117(1):286-300.
Murray JC. Keloids and hypertrophic scars. Clin. Dermatol. 1994;12:27.
Blackburn WR, Cosman B. Histologic basis of keloid and hypertrophic scar differentiation: Clinicopathologic correlation. Arch Pathol. 1966;82:65.
Sussman MD. Effect of increased tissue traction upon tensile strength of cutaneous incisions in rats. Proc Soc Exp Biol Med. 1966;123:38.
Norris JE. Superficial X-ray therapy in keloid management: A retrospective study of 24 cases and literature review. Plast Reconstr Surg. 1995;95:1051.
Fitzpatrick RE. Treatment of inflamed hypertrophic scars using intralesional 5-FU. Dermatol Surg. 1999;25:224.
Ladin DA, Hou Z, Patel D. p53 and apoptosis alterations in keloids and keloid fibroblasts. Wound Repair Regen. 1998;6:28–37.
Satish L, Lyons-Weiler J, Hebda PA, Wells A. Gene expression patterns in isolated keloid fibroblasts. Wound Repair Regen. 2006;14:463–70.
Seifert O, Bayat A, Geffers R. Identification of unique gene expression patterns within different lesional sites of keloids. Wound Repair Regen. 2008;16:254–65.
Peacock EE, Madden JW, Trier WC. Biologic basis for the treatment of keloids and hypertrophic scars. South Med J. 1970;63:755.
Griffith BH, Monroe CW, McKinney PA. Follow-up study on the treatment of keloids with triamcinolone acetonide. Plast. Reconstr. Surg. 1970;46:145.
