Assessment of the effect of phenytoin on cutaneous healing from excision of melanocytic nevi on the face and on the back.
BACKGROUND
Topical phenytoin is a powerful skin wounds healing and it may be useful in clinical practice. The purpose of this study was to evaluate the effect of topical phenytoin 0.5%, by comparing it with cream (control) in wounds resulting from excision of two melanocytic nevi in the same patient. Our purpose was also to assess if phenytoin had better therapeutic and cosmetic outcomes when compared with cream (control).


METHODS
This study evaluated 100 patients with skin wounds from excision of melanocytic nevi. 50 patients with lesions on the face and 50 patients with lesions on the back, totalizing 200 lesions excised with modified punch. The resulting superficial skin wounds had the same diameter and depth, and second intention healing followed.Patients were followed for 60 days. Student's t-test, Mann Whitney nonparametric test, analysis of variance, LSD test, Shapiro-Wilks test and Fisher test were used to analyze the results, depending on the nature of the variables being studied.


RESULTS
Phenytoin showed better therapeutic and cosmetic results, by healing faster, with more intense epithelization in wounds in comparison with cream (control). Phenytoin showed a statistically significant difference regarding the following parameters (p < 0.05): wounded area and healing time. Phenytoin application resulted in a smaller area and a shorter healing time. Also the intensity of exudates, bleeding, and the epithelization were more intense in phenytoin-treated wounds. Regarding the shape and thickness of the scar, injuries treated with phenytoin had round and flat shaped scars in most of the cases. Considering patient's gender and phototype, female patients presented smaller wounds and scar areas; and phototype I had the largest scar areas. Contact eczema was an adverse reaction in 7 injuries located on the back caused by cream (control) and hypoallergenic tape.


CONCLUSIONS
Phenytoin showed better therapeutic and cosmetic results compared with cream (control). Phenytoin is a low cost drug, which accelerates skin wounds healing in human patients.


BACKGROUND
ISRCTN96539803.
Pereira
Carlos Augusto Zanardini
CA
Dermatology Service, Hospital Santa Casa de Curitiba, Pontifícia Universidade Católica do Paraná, Brazil. carloszpereira@milenio.com.br
Alchorne
Alice de Oliveira de A
Ade O
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects; D004643:Emollients / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology / Q000601:surgery*; D010672:Phenytoin / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing / Q000187:drug effects*; D055815:Young Adult
D003879:Dermatologic Agents; D004643:Emollients; D010672:Phenytoin