Keloid formation after syndactyly release in patients with associated macrodactyly: management with methotrexate therapy

Tolerton, Sarah K; Tonkin, Michael A.

doi:10.1177/1753193411402146

Cited by 27 publications

(30 citation statements)

References 42 publications

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“…The exception to this rule is mentioned above, for simple volar debulking. If signs of scar hypertrophy are appreciated early postoperatively, we recommend a 10-week course of oral methotrexate (0.5 mg/kg weekly) and folic acid (5 mg/wk) 11 with appropriate surveillance laboratory values, as described by Muzaffer et al 12 This has been shown to have an insignificant side-effect profile at these low doses for such a short period of time. Ideally a pediatric rheumatologist should be available to help with dosing and duration of treatment as well as trending of laboratory values.…”

Section: Pearls and Pitfallsmentioning

confidence: 98%

Surgical Treatment of Macrodactyly

Gluck¹,

Ezaki²

2015

The Journal of Hand Surgery

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Section: Pearls and Pitfallsmentioning

confidence: 98%

Surgical Treatment of Macrodactyly

Gluck¹,

Ezaki²

2015

The Journal of Hand Surgery

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“…In addition, this combination therapy relieves itching that is mediated by the increased amount of histamine secreted by mast cells in keloid tissue [20,[25][26][27]].…”

Section: Discussionmentioning

confidence: 99%

“…Methotrexate (MTX) is used for the treatment of cancer, psoriasis, and rheumatoid arthritis, and works by inhibiting dihydrofolate reeducates, which prevents the reduction of dihydrofolate to its active form, [25] but MTX has not been tried as intralesional treatment for keliod. Researchers are always looking for new therapy that could be more satisfactory than old treatment.…”

Section: Introductionmentioning

confidence: 99%

Debulking of Keloid Combined with Intralesional Injection of Methotrexate and Triamcinolone versus Intralesional Injection of Methotrexate and Triamcinolone

Sharquie¹

2014

CDT

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Background: Keloid is a major health problem all over the world, where its management is a complex problem. Objective: To find new mode of therapy for keloid by using intralesional injection of methotrexate and triamcinolon with or without debulking. Patient and Methods: This single blinded comparative therapeutic outpatient based study was done at the Department of Dermatology, Baghdad Teaching Hospital during the period from February 2011 to February 2013. A total of 27 patients with 61 lesions were enrolled in this work and consisted of 2groups; Group A (30 lesions): Treated by intralesional injection of combination of methotrexate and triamcinolone acetonide and repeated every month. Group B (31 lesions) Debulking was carried out first and then injection of combination of methotrexate and triamcinolone acetonide at time of operation similar to Group A. Evaluation was performed by scoring system with 5 criteria (redness, elevation, hardness, itching and tenderness). The response was graded as no response, minimal, moderate or complete response.

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“… 1 – 9 Nearly all were reported to occur after a surgery for treating syndactyly, macrodactyly, or ingrown nail. 1 – 3 , 5 – 9 Some were difficult to treat. 3 A few could be treated conservatively, for example by steroid injection.…”

mentioning

confidence: 99%

“… 1 , 5 Others required surgery, which often consisted of total excision and full-thickness skin grafting. 1 , 2 , 4 – 9 A good surgical alternative may be the core-excision method, where the fibrous mass of the keloid is removed and the tissue retained over the keloid serves as a flap. This method is highly effective with auricular keloids.…”

mentioning

confidence: 99%

Toe Keloids Treated with Core Excision, Postoperative Radiotherapy, and Steroid Plaster

Kaku

Matsunaga

Kuribayashi

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Summary: Although keloids are common on the joints, precordial areas, and abdomen, toe keloids are rare. The limited literature to date also suggests that they can be difficult to treat. We experienced the case of a 21-year-old woman with toe keloids on the first, second, and third toes that arose after ingrown-nail operations at another hospital. The second toe keloid was resected but recurred. Since subsequent conservative treatments were ineffective, the patient was referred to our hospital. The first visit revealed three large keloids: in particular, the keloid on the second toe had engulfed the entire circumference of the toe. Surgery with the core-excision method and postoperative radiotherapy were performed. After the sutures were removed, the scars were treated for 24 hours/day with steroid plaster until the induration disappeared. One and a half years after the operation, recurrence was not observed and the appearance of the toes had improved greatly. Thus, combination therapy composed of core excision, radiotherapy, and steroid plaster therapy is highly effective for toe keloids.

show abstract

Keloid formation after syndactyly release in patients with associated macrodactyly: management with methotrexate therapy

Cited by 27 publications

References 42 publications

Surgical Treatment of Macrodactyly

Surgical Treatment of Macrodactyly

Debulking of Keloid Combined with Intralesional Injection of Methotrexate and Triamcinolone versus Intralesional Injection of Methotrexate and Triamcinolone

Toe Keloids Treated with Core Excision, Postoperative Radiotherapy, and Steroid Plaster

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