Bleomycin in the Treatment of Keloids and Hypertrophic Scars by Multiple Needle Punctures

Abstract

Background. The treatment of keloids and hypertrophic scars has been difficult and a recent French study showed that bleomycin has been useful in the treatment of these lesions. Objective. To determine the effectiveness and safety of bleomycin in the treatment of hypertrophic scars and keloids when this drug is administered through multiple superficial punctures. Methods. We applied bleomycin to keloids and hypertrophic scars in 13 patients using a multiple-puncture method on the surface of the skin. All patients were given bleomycin at a concentration of 1.5 IU/ml. Clinical response after treatment was classified according to the following scale: complete flattening (100%), highly significant flattening (>90%), or significant flattening (75-90%). Results. The clinical response was very positive in all cases: complete flattening in six cases, highly significant flattening in six cases, and significant flattening in one case. Two patients presented a recurrence as a small nodule 10 and 12 months after the last infiltration. Conclusions. These clinical findings show that administration of bleomycin in keloids and hypertrophic scars shows promise and needs further investigation.

Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies

“…After administering three to five intralesional injections of bleomycin within a 1-month period, the authors observed complete regression in 69.4% of the keloids. Subsequent studies revealed similar results, with significant improvement in hypertrophic scar and keloid height and pliability as well as reduction in erythema, pruritus and pain (135,137,138). Occasionally, development of hyperpigmentation and dermal atrophy may occur with bleomycin treatment.…”

Downregulation of Scar Fibroblasts by Antineoplastic Drugs: A Potential Treatment for Fibroproliferative Disorders

“…Finally, bleomycin can cause pulmonary, renal, and cutaneous fibrosis at high doses. Doses of bleomycin used for intralesional punctures have shown less than 5% systemic absorption [32]. Ifthese side effects can be minimized or eliminated, treatment with antineoplastic drugs may be feasible for fibroproliferative disorders that have many of the same characteristics of malignancies.…”

Narbe und Keloid – und nun?

“…Mögliche Nebenwirkungen sind Hautirritationen, Schmerzen während der Injektion, Ulzerationen und Purpura. Auch über intraläsionales Bleomycin existieren durchaus positi− ve Studienergebnisse [24,25]. Durch ein ¹Einpricken" der Sub− stanz, d. h. externes Auftragen und anschließende Punktion mit einer Nadel, findet eine geringere Resorption statt.…”