Topical tamoxifen therapy in hypertrophic scars or keloids in burns.
As acute burn patients have experienced increasing survival rates, the number of patients who need specific care due to aberrant scarring is also increasing. The burned skin often responds with fibrotic tissue proliferation, which can lead to a hypertrophic scar or a keloid. Non-physiologic scars are mostly not acceptable for the burn patient. Intradermal and topical therapy in burns comprise the treatment of the skin injury and its possible texture, elasticity and color alterations with the aid of active substances that result in fibroblastic modulation. An alteration of cytokine levels may mediate these effects, and evidences suggest that keloid scar formation may be mediated, in part, by deranged growth factor activity, including that of transforming growth factor (TGF)-beta(1). The addition of tamoxifen, a non-steroidal anti-estrogen, usually used in breast cancer, to standard treatment may lead to improved wound healing in keloids by decreasing the expression of TGF-beta(1), with the consequent inhibitions of both fibroblast proliferation and collagen production. Topical tamoxifen citrate chemical treatment has been shown to improve scarring. However, prospective studies must be undertaken to validate the inclusion of tamoxifen into standard clinical practice.
Gragnani
Alfredo
A
Division of Plastic Surgery, Department of Surgery, Federal University of Sao Paulo, Napoleão de Barros St 715, 4th Floor, Sao Paulo 04024-002, SP, Brazil. alfredogf@ig.com.br
Warde
Mario
M
Furtado
Fabianne
F
Ferreira
Lydia Masako
LM
D000287:Administration, Topical; D002056:Burns / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D002454:Cell Differentiation / Q000187:drug effects; D002460:Cell Line; D049109:Cell Proliferation / Q000187:drug effects; D017439:Cicatrix, Hypertrophic / Q000188:drug therapy* / Q000473:pathology; D005347:Fibroblasts / Q000187:drug effects / Q000378:metabolism* / Q000473:pathology; D005355:Fibrosis; D006801:Humans; D007627:Keloid / Q000188:drug therapy* / Q000473:pathology; D012867:Skin / Q000187:drug effects / Q000293:injuries / Q000473:pathology; D013629:Tamoxifen / Q000008:administration & dosage*; D053773:Transforming Growth Factor beta1 / Q000378:metabolism; D014945:Wound Healing / Q000187:drug effects
D053773:Transforming Growth Factor beta1; D013629:Tamoxifen