The efficacy of 5% imiquimod cream in the prevention of recurrence of excised keloids.
OBJECTIVE
To evaluate the efficacy of 5% imiquimod cream in the prevention of recurrence of excised keloids.


METHODS
The patients with keloids that had occurred over 1 year and could be excised and primary sutured were enrolled in the study. Imiquimod 5% cream was applied to the scar 7 days after stitches removal. The patients were follow-up for recurrence and drug side effect at 4, 6, 8, 16, and 24 weeks.


RESULTS
Forty-five patients enrolled to the study but only 35 patients finished the study. The keloids were at the pinnas in 22 patients, at the backs or shoulders in 7 patients, and at chest walls or necks in 6 patients. Imiquimod 5% cream was applied on the wound area 2 weeks after the operation, at alternate night for 8 weeks. The follow-up period ranged from 6 to 9 months. Ten of the treated keloids recurred (28.6% recurrent rate). The lesion at the pinna had the lowest recurrent rate (2.9% recurrent of the total patients). The highest recurrent rate occurred at the chest wall or neck (83.3% recurrent of the chest wall or neck or 14.3% of the total patients). Side effects were found in thirteen patients (37.1%). These were abrasions of the skin around the wound areas in ten patients and hyperpigmentation of the skin around the wounds in three patients.


CONCLUSIONS
Imiquimod 5% cream could effectively prevent recurrence of the excised keloids, especially in the area that had less tension such as pinna.
Chuangsuwanich
Apirag
A
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pranok Rd, Siriraj Hospital, Bangkoknoi, Bangkok 10700, Thailand. apirag@gmail.com
Gunjittisomram
Suriya
S
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D000077271:Imiquimod; D007369:Interferon Inducers / Q000008:administration & dosage / Q000627:therapeutic use*; D007627:Keloid / Q000517:prevention & control* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D055502:Secondary Prevention; D013997:Time Factors; D014945:Wound Healing / Q000187:drug effects
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D007369:Interferon Inducers; D000077271:Imiquimod