Intralesional vs. contact cryosurgery in treatment of keloids: a clinical and immunohistochemical study

Abstract

Intralesional cryosurgery is superior to contact cryosurgery in terms of efficacy and safety. Both techniques may have beneficial effects on keloids, at least partially, through the modulation of VEGF and tenascin C expression.

Intralesional cryotherapy for hypertrophic scars and keloids: a review

“…The largest study reviewed contained 95 patients. 19 However, the median number of patients per study was 17. The published evidence base for this technique was uniformly Level 4.…”

“…Weshahy and Ebdel Hay, using a different cryoneedle to that popularised by Har-Shai, reported mean scar volume reductions of 93.5% in 20 patients at four months after treatment 18 and Abdel-Meguid et al, from the same centre, observed mean scar volume reductions of 61% following intralesional cryotherapy, compared with reductions of 23% with contact cryotherapy. 19 However, it is unclear if the effect persisted in the long term. Roitman et al reported in two patients persistence of 100% keloid scar reduction at six months following single procedures.…”

“…There is some evidence of increasing usage of intralesional cryotherapy in the treatment of hypertrophic scars and keloids. 15 – 22 In addition, the technique has been applied to other pathologies, including treatment of skin cancer, with favourable results, 26 although the term ‘intralesional’ in this case is wrong and possibly dangerous. The term ‘transcutaneous’ has been suggested as an alternative.…”

Histological analysis of hyalinised keloidal collagen formation in earlobe keloids over time: collagen hyalinisation starts in the perivascular area

“…The treatment for keloids in general include intralesional corticosteroid and 5‐fluorouracil injections, silicone gel sheeting, pressure therapy, laser therapy, cryotherapy and surgical therapy followed by postoperative radiotherapy . Although there is no single definitive treatment modality for keloids, combinations of several therapeutic regiments can be used depending on the race, age and gender of the patient and the size, duration, location, colour, shape and symptoms of the keloid .…”

Promising novel treatment against keloids: Antivascular endothelial growth factor agents

“…[4] The importance of VEGF in the development and exaggerated of hypertrophic scar and keloid had led to trials of medications with antivascular and antiangiogenesis properties. [5] Previous in vitro studies also suggested that corticosteroids can suppress the synthesis of VEGF. [6] Hence, modulation of VEGF production could comprise an appreciated treatment modality for keloids.…”