KECORT Study: An International e-Delphi Study on the Treatment of KEloids Using Intralesional CORTicosteroids in Clinical Practice.

Autor: Yin Q; Department of Dermatology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands. q.yin@amsterdamumc.nl., Wolkerstorfer A; Department of Dermatology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands., Lapid O; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.; Pediatric Surgical Centre, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.; Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Amsterdam, The Netherlands., Qayumi K; Department of Dermatology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands., Alam M; Departments of Dermatology, Otolaryngology, Surgery, and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Al-Niaimi F; Taktouk Clinic, London, UK.; Aalborg University Hospital, Aalborg, Denmark., Artzi O; Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., van Doorn MBA; Department of Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands.; Centre for Human Drug Research, Leiden, The Netherlands., Goutos I; The London Scar Clinic, 152 Harley Street, London, W1G 7LH, UK., Haedersdal M; Department of Dermatology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark., Hsu CK; Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan., Manuskiatti W; Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Monstrey S; Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium., Mustoe TA; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Ogawa R; Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan., Ozog D; Department of Dermatology, Henry Ford Health, Detroit, MI, USA.; Department of Medicine, Michigan State University School of Medicine, East Lansing, MI, USA., Park TH; Department of Plastic and Reconstructive Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea., Pötschke J; Department of Plastic and Handsurgery, Burn Center, Klinikum St. Georg gGmbH, Leipzig, Germany., Rossi A; Memorial Sloan Kettering Cancer Center, 530 East 74th Street, Office 9104, New York, NY, 10021, USA., Tan ST; Gillies McIndoe Research Institute, Wellington, New Zealand.; Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital, Wellington, New Zealand., Téot L; Department of Plastic Surgery, Montpellier University Hospital, Montpellier, France., Wood FM; Burns Service of Western Australia, Fiona Stanley Hospital, Perth Childrens Hospital, University of Western Australia, Crawley, Australia., Yu N; Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China., Gibbs S; Department of Molecular Cell Biology and Immunology, Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.; Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands., Niessen FB; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands., van Zuijlen PPM; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.; Pediatric Surgical Centre, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.; Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Amsterdam, The Netherlands.; Burn Center and Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands.
Jazyk: angličtina
Zdroj: American journal of clinical dermatology [Am J Clin Dermatol] 2024 Nov; Vol. 25 (6), pp. 1009-1017. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1007/s40257-024-00888-7
Abstrakt: Background: Intralesional corticosteroid administration (ICA) is a first-line keloid treatment. However, it faces significant variability in current clinical and scientific practice, which hinders comparability of treatment results.
Objectives: The aim of the study was to reach consensus on different aspects of ICA using hypodermic needles in keloids among an international group of dermatologists and plastic surgeons specialized in keloid treatment to provide consensus-based clinical treatment recommendations for all physicians treating keloids.
Methods: The keloid expert panel of 12 dermatologists and 11 plastic surgeons rated 30 statements. Two online e-Delphi rounds were held, both with a response rate of 100%. Fifteen (65%) keloid experts participated in the final consensus meetings. Consensus was defined as ≥ 75% of the participants choosing agree or strongly agree on a 7-point Likert scale.
Results: Consensus was reached on treatment goals, indication for ICA, triamcinolone acetonide (TAC) 40 mg/mL as the preferred corticosteroid administered at a maximum of 80 mg per month and at intervals of 4 weeks, minimizing pain during ICA, the use of 1 mL syringes and 25 or 27 Gauge needles, blanching as endpoint of successful infiltration, caution of not injecting subcutaneously, and the option of making multiple passes in very firm keloids prior to infiltration. Consensus could not be reached on TAC dosing, methods of prior local anesthesia, and location of injection.
Conclusions: This e-Delphi study provides important clinical treatment recommendations on essential aspects of ICA in keloids. By implementing these recommendations, uniformity of ICA in keloid treatment will increase and better treatment results may be achieved.
(© 2024. The Author(s).)
Databáze: MEDLINE
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