Pharmacological treatment for keloids.
BACKGROUND
Keloids are fibroproliferative disorders that are characterized by histological accumulation of collagens and fibroblasts, refractory clinical symptoms such as itching, topical invasiveness, and frequent postsurgical recurrence. At present, to treat or prevent keloids, new drugs are currently being designed and the pharmaceutical indications of known drugs are being expanded.


METHODS
The current pharmacological interventions for keloids are mainly described on the basis of the various hypotheses on keloid etiology and the keloid ingredients that are targeted. These interventions include angiotension-converting enzyme inhibitors and calcium-channel blockers (based on hypertension hypothesis), selective estrogen receptor modulator (based on endocrinological hypothesis), vitamins and essential fatty acids (based on immunonutritional hypothesis), and transglutaminase inhibitor (based on metabolic hypothesis). Drugs that directly target the reduction or destruction of the major extracellular matrix or cellular constituents of keloids are also included. Besides, drugs that indirectly modulate the biochemical microenvironment are described. These include growth factors, immunomodulators, and anti-inflammation and anti-allergy drugs.


CONCLUSIONS
Due to the unclear etiology of keloids and the lack of animal models, efficient, reliable, and specific pharmaceutical interventions for keloids continue to be lacking. The reliability of current data and clinical observations must be strengthened by large-scale, randomized, controlled clinical trials.
Nippon Medical School, Department of Plastic, Reconstructive and Aesthetic Surgery, Tokyo , 1-1-5 Sendagi Bunkyo-ku , Japan +81 3 5814 6208 ; +81 3 5685 3076 ; r.ogawa@nms.ac.jp.
Chenyu
C
Huang
Rei
R
Ogawa
D000818:Animals; D005109:Extracellular Matrix; D005347:Fibroblasts; D006801:Humans; D007627:Keloid / Q000188:drug therapy* / Q000209:etiology