Safety and efficacy of intralesional bleomycin for keloids and hypertrophic scars: A systematic review and meta-analysis.

Autor: You SJ; Plastic and Reconstructive Surgery & Burns, Affiliated Hospital of North Sichuan Medical College, Sichuan, Nanchong, China., Li S; Dermatology, Affiliated Hospital of North Sichuan Medical College, Sichuan, Nanchong, China., Hu CM; Department of Vascular Surgery Dazhou, Sichuan, Nanchong, China., Zhong FY; Plastic and Reconstructive Surgery & Burns, Affiliated Hospital of North Sichuan Medical College, Sichuan, Nanchong, China., Gan SH; Plastic and Reconstructive Surgery & Burns, Affiliated Hospital of North Sichuan Medical College, Sichuan, Nanchong, China., Cai Y; Genetics and Prenatal Diagnosis Center, Affiliated Hospital of North Sichuan Medical College, Sichuan, Nanchong, China., Xiang XY; Plastic and Reconstructive Surgery & Burns, Affiliated Hospital of North Sichuan Medical College, Sichuan, Nanchong, China.
Jazyk: angličtina
Zdroj: Journal of cosmetic dermatology [J Cosmet Dermatol] 2024 Nov; Vol. 23 (11), pp. 3444-3455. Date of Electronic Publication: 2024 Aug 28.
DOI: 10.1111/jocd.16447
Abstrakt: Background: Bleomycin, originally an antitumor drug, was explored as a pathological scar treatment in the mid-1990s. However, its efficacy and safety profile varies among individuals.
Aims: This study aimed to assess topical bleomycin's efficacy and safety in treating hypertrophic scars and keloids.
Methods: We reviewed randomized controlled trials (RCTs) and controlled clinical trials (CCTs) published in English, comparing intralesional bleomycin to placebos or common intralesional scar treatments. Primary outcomes included percentage change in scar improvement, pigmentation, recurrence, atrophy, pain, telangiectasia, ulceration, patient self-assessment, and observer assessment (>50%).
Results: Six trials met the criteria. Bleomycin significantly improved scar reduction compared to triamcinolone (p < 0.05). There was no significant difference in pigmentation (p = 0.05) and recurrence (p = 0.21) compared to other treatments. In terms of safety, bleomycin caused less skin atrophy (p < 0.01) and telangiectasia (p < 0.01) but more pain (p = 0.03) than other treatments.
Conclusions: Bleomycin was more effective than TAC, 5-FU, or TAC combined with 5-FU for treating keloids and hypertrophic scars with lower skin atrophy and telangiectasia risks. However, it may cause more pain than 5-FU or TAC. Further comprehensive studies, including RCTs, are required for objective analysis.
(© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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