Treatment of keloids and hypertrophic scars using bleom.
BACKGROUND
Numerous treatments have been attempted with unsatisfactory results using either single or combination modalities for treatment of keloids and hypertrophic scars. The aim of our study was to determine the effectiveness and safety of bleomycin in the treatment of hypertrophic scars and keloids.


METHODS
This study included 50 patients with keloids and hypertrophic scars. Bleomycin was administered through multiple superficial puncture technique. Three applications were given at intervals of 15 days each, followed by a fourth and final application 2 months after the last application. Final results were read 2 months after the last application. Results were evaluated according to change in size as follows: Group Response. a. Complete flattening (100% regression). b. Significant flattening (75-99% regression). c. Adequate flattening (50-74% regression). d. Inadequate flattening (less than 50%). Patients were assessed for any complication of bleomycin (systemic as well as local) and recurrence of keloids and hypertrophic scars. Regular follow-up for side-effects was done for 18 months.


RESULTS
Out of 50 patients, complete flattening was observed in 22 cases (44%); significant flattening in 11 cases (22%); and adequate flattening was observed in 7 cases (14%). Only 10 cases (20%) did not show any satisfactory flattening. Pruritus was relieved completely in 40 patients (88.88%). Recurrence was seen in seven patients.


CONCLUSIONS
Bleomycin is easy to administer, is cheap, shows high regression rate, and has minimum complication and recurrence. Thus, it can be used as the first-line treatment modality for management of keloids and hypertrophic scars.
Aggarwal
Himanshu
H
Department of Surgery, M.G.M. Medical College and M.Y. Group of Hospitals, Indore, Madhya Pradesh, India. nickeylubana@rediffmail.com
Saxena
Anurag
A
Lubana
Parvinder S
PS
Mathur
R K
RK
Jain
D K
DK
D000293:Adolescent; D000328:Adult; D001761:Bleomycin / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D017439:Cicatrix, Hypertrophic / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D003603:Cytotoxins / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D012867:Skin / Q000293:injuries / Q000473:pathology; D016896:Treatment Outcome
D003603:Cytotoxins; D001761:Bleomycin