Intralesional pentoxifylline, triamcinolone acetonide, and their combination for treatment of keloid scars

Serag-Eldin, Yasmin Magdy Abdulrahman; Mahmoud, Wael Hussein; Gamea, Mohamed M; Hegab, Doaa Salah

doi:10.1111/jocd.14305

Cited by 12 publications

(10 citation statements)

References 32 publications

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“…The most commonly described treatment interval was every 4 weeks (50%), followed by every 3 weeks (29%), weekly (15%), and every 2 weeks (6%). Six studies mentioned that treatment would be stopped if complete lesion flattening or clearance occurred [10,18,[28][29][30][31] (Table 1).…”

Section: Drugs and Dosingmentioning

confidence: 99%

“…Reported needle sizes were 26 (brown, 0.45 mm), 27 (medium gray, 0.40 mm), and 30-gauge (yellow, 0.30 mm), which were used in, respectively, one [17], seven [11,12,14,16,18,19,34], and three studies [28,31,35]. Twenty-seven (71%) studies did not report the needle size.…”

Section: Equipmentmentioning

confidence: 99%

“…The syringe size was only specified in four studies, being 1 mL [11,16,35,36]. Seven (18%) studies reported the use of an insulin syringe, without mentioning its size [6,18,20,23,28,31,37] (Table 1).…”

Section: Equipmentmentioning

confidence: 99%

“…Two studies mentioned the speed of injection, being 0.5-1.0 mL per minute and 0.1 mL per 10-15 s [21,22]. Blanching was reported in ten (26%) studies as an endpoint indicating adequate TAC distribution [6,11,13,17,23,28,[31][32][33]35] (Table 1).…”

Section: Manual Injection Techniquesmentioning

confidence: 99%

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Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

et al. 2023

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Background Intralesional corticosteroid administration (ICA) is a first-line treatment for keloids. However, its clinical results are still highly variable and often suboptimal. Treatment results may strongly be influenced by various operator dependent factors. The aim of this study is to map the details of ICA in keloids described in randomized controlled trials (RCTs), hence presenting the scientific practice of a first-line treatment for keloids in the best available evidence. Summary A systematic search was performed on PubMed, Ovid MEDLINE, Ovid EMBASE and CENTRAL. Eligible studies were RCTs including patients with keloids treated with intralesional corticosteroids. Treatment and study design related data were charted on a predefined form. Thirty-eight RCTs were included for data extraction. Triamcinolone acetonide was used in 37 (97.4%) studies. Dosing per cm2 could only be compared among ten (26%) studies, and varied from 1 to 20 mg. The maximum dose per session varied from 20 to 80 mg. Anesthetics were administered locally and orally in seven and one RCT(s). Treatment intervals varied from weekly to monthly, with four weeks most frequently (50%) used. Needle size was reported in eleven (29%) studies and varied from 26 to 30-gauge. Syringe size was specified in four (11%) studies, being 1 mL. The injection level was described in eleven (29%) studies. Blanching as endpoint was reported in ten (26%) studies. Outcome measures varied widely, from height, surface area or volume, to Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, pain and itch scores, patient satisfaction and different efficacy rates. Only six studies had a follow-up of ≥6 months. Recurrence was identified in two studies with 18 weeks and 1 year of follow-up. Adverse events were reported in 25 (66%) studies. Key messages There is incomplete reporting and substantial heterogeneity in many aspects of ICA and study design among RCTs. This scoping review underscores the urgent need for standardization of treatment protocol and study design to enhance and uniform research conduct among keloid studies.

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Section: Drugs and Dosingmentioning

confidence: 99%

Section: Equipmentmentioning

confidence: 99%

Section: Equipmentmentioning

confidence: 99%

Section: Manual Injection Techniquesmentioning

confidence: 99%

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Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

et al. 2023

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“…It is worth noting that in those strictly designed clinical trials, PTX was very effective to alleviate radiotherapy-related fibrosis and even osteonecrosis when treating a variety of cancer patients, including non-small cell lung cancer, pelvic cancer, head and neck squamous cell carcinoma, breast cancer, and so on ( Kwon et al, 2000 ; Aygenc et al, 2004 ; Gothard et al, 2005 ; Haddad et al, 2005 ; Delanian et al, 2011 ; Jacobson et al, 2013 ; Cook et al, 2016 ). PTX was helpful to treat abnormal superficial fibrosis such as skin hypertrophic scar and oral submucosal fibrosis, and it also contributed to controling the development of organ fibrosis such as liver fibrosis, systemic sclerosis, and cystic fibrosis ( Futran et al, 1997 ; de Souza et al, 2009 ; Alam et al, 2017 ; Sadaksharam and Mahalingam, 2017 ; Kholakiya et al, 2020 ; Tan et al, 2020 ; Kedarisetty et al, 2021 ; Serag-Eldin et al, 2021 ). For the specific mechanisms behind this anti-fibrosis effect, some researchers have illustrated that PTX treatment was capable of inhibiting the proliferation and extracellular matrix production of fibroblasts ( Kaya et al, 2014 ; Lee et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Pentoxifylline Inhibits Pulmonary Fibrosis by Regulating Cellular Senescence in Mice

Lin

Zhou

et al. 2022

Front. Pharmacol.

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Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disease, and its occurrence and development are mediated by cellular senescence. Drugs targeting senescent cells seem like a promising and efficacious strategy for IPF treatment. Previous studies have illustrated that pentoxifylline (PTX) may play a certain role in inhibiting pulmonary fibrosis and combating cellular senescence. In this study, we demonstrated that PTX administration inhibits pulmonary fibrosis development and cellular senescence in the bleomycin (BLM)-induced IPF mice model. Moreover, the expression levels of fibrosis-related genes and senescence-related genes in mice lung tissue and primary pulmonary fibroblasts illustrated lung fibroblasts’ vital role in these two processes. And the curative effect of PTX was completed mainly by acting on lung fibroblasts. Besides, during the whole treatment, delayed initiation or advanced halt of PTX administration would influence its effectiveness in reducing fibrotic and senescent traits in various degrees, and the latter influenced more. We further determined that a long period of PTX administration could bring noticeable benefits to mice in recovering BLM-induced lung fibrosis and suppressing age-associated cellular senescence. Moreover, it was still effective when PTX administration was used to treat senescent human fibroblasts. Thus, our findings manifested that PTX therapy is an efficient remedy for pulmonary fibrosis by suppressing cellular senescence.

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Evidence-based management of keloids and hypertrophic scars in dermatology

2022

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Intralesional pentoxifylline, triamcinolone acetonide, and their combination for treatment of keloid scars

Cited by 12 publications

References 32 publications

Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

Pentoxifylline Inhibits Pulmonary Fibrosis by Regulating Cellular Senescence in Mice

Evidence-based management of keloids and hypertrophic scars in dermatology

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