Role of vitamin D in treatment of keloid

Abstract

Background Keloid is a benign well‐demarcated overgrowth of fibrotic tissue which extends beyond the original boundaries of a defect. The treatment of keloids is a particular challenge to dermatologists. Intralesional corticosteroid injection has been considered the first‐line treatment for keloids. Vitamin D plays an important role in cell proliferation and differentiation as it slows the progression of tissue fibrosis by keloid fibroblasts and inhibits collagen synthesis in dermal fibrosis. Objectives To evaluate the efficacy of intralesional injection of vitamin D in the treatment of keloids, both clinically and ultrasonically. Methods Forty Egyptian patients with keloid scars were injected weekly with intralesional vitamin D with dose of 0.2 ml (200,000 IU) per 1 cm lesion. The keloid scars were evaluated with Vancouver Scar Scale (VSS) and by a high‐resolution ultrasound using B mode before and after treatment, the patients received 3 to 4 sessions. Results There was statistically highly significant reduction in VSS after treatment with intralesional vitamin D injection (p value≤0.001). There was also statistically highly significant improvement in ultrasonic keloid scar thickness after treatment (P value ≤0.001). Conclusions Intralesional vitamin D is an effective and safe method in treatment of keloid scars. Ultrasound is a useful method in assessing the improvement of keloids after treatment.

A role for vitamin D and the vitamin D receptor in keloid disorder

“…Additionally, there may be therapeutic benefit to local administration of vitamin D to keloid tissue. The study by Mamdouh et al suggests that injection of vitamin D into keloids may help reduce their severity, 139 but larger, well‐controlled studies are needed, with longer follow‐up periods, to determine if vitamin D injections have similar efficacy to other injectable drugs, such as triamcinolone and 5‐fluorouracil 10 . Finally, understanding how vitamin D signalling through VDR interacts with other signalling pathways to modulate wound healing may help us to elucidate the molecular mechanisms underlying keloid formation, which could help in design of more targeted and effective therapies.…”

“…Additionally, calcitriol treatment was able to inhibit TGF‐β1‐induced increases in expression of type I collagen, fibronectin and alpha smooth muscle actin in keloid fibroblasts 136 . Recently, Mamdouh et al performed a clinical trial to investigate the efficacy of vitamin D injection for reduction of keloid severity, which was rated using the Vancouver Scar Scale and ultrasound 139 . Forty patients with keloids 1–5 cm in size were enrolled and keloids were injected with 200,000 IU vitamin D per 1 cm lesion; injections were performed weekly for up to 3–4 sessions.…”

“…Forty patients with keloids 1–5 cm in size were enrolled and keloids were injected with 200,000 IU vitamin D per 1 cm lesion; injections were performed weekly for up to 3–4 sessions. The authors reported that 2 months after conclusion of the treatment regimen, there were significant reductions in mean Vancouver Scar Scale ratings and scar height measured using ultrasound 139 . Minor side effects including temporary pain, redness, swelling and tenderness were observed in approximately half of patients, and a majority of patients expressed satisfaction with the results 139 .…”

Intralesional vitamin D injection for management of keloids

“…This was supported by the study of Mamdouh et al, who observed significant reduction in VSS in a case series of 40 patients with keloids treated with four sessions of weekly intralesional vitamin D injections. 5 In conclusion, vitamin D is a safe, effective and inexpensive treatment modality for keloids. Its lack of AEs such as pigment alteration, atrophy, telangiectasias, etc.…”

Vitamin D Deficiency and Keloids: Causal Factor or Bystander?

“…Recently, in a study enrolling 40 patients with keloid lesions, weekly intralesional injection of VD with a dose of 0.2 mL (200,000 IU) per 1 cm lesion was beneficial in improving keloid scars [15]. This finding suggests intra­lesional VD as a novel, safe, and effective option for future treatment of keloid lesions.…”