title: Positive response of a recurrent keloid scar to topical methyl aminolevulinate-photodynamic therapy.
abstract: A 36-year-old Caucasian female of Iranian origin presented with a persistently raised dermal lesion under her chin, confirmed histologically to be a keloid scar. There was a 4-year history of a negative response to a range of conventional treatments including topical silicone gel sheets, steroid creams, steroid injections and surgical excision. In view of treatment failure and an in vitro study indicating a positive effect of photodynamic therapy (PDT)on keloid fibroblasts, we treated our patient's lesion with five sessions of methyl aminolevulinate photodynamic therapy (MAL-PDT) over a period of 5 months. Following this treatment regime, her keloid scar had considerably reduced in size and become flattened.The surface of the keloid also became smooth, with attenuation in erythema at the margin as well as an improvement in the colour of the scar, which was better matched to the surrounding skin. There was no recurrence at 1-year follow-up and this treatment resulted in an overall acceptable cosmetic outcome. This case report presents PDT as a potential treatment option for persistent keloid lesions unresponsive to conventional scar modulation therapies and suggests a need for further research in this area.
authors.affiliation: Photobiology Unit, Dermatology Centre, Salford Royal NHS Foundation Hospital, Stott Lane, Salford, Manchester M68HD, UK. zhuxiang.nie@manchester.ac.uk
authors.forename: Zhuxiang
authors.initials: Z
authors.lastname: Nie
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Bayat
authors.forename: Farhad
authors.initials: F
authors.lastname: Behzad
authors.forename: Lesley E
authors.initials: LE
authors.lastname: Rhodes
mesh_terms: D000328:Adult; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D005347:Fibroblasts / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007627:Keloid / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D012074:Remission Induction; D013997:Time Factors
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid