title: Treatment of keloids with laser-assisted topical steroid delivery: a retrospective study of 23 cases.
abstract: Topical or intralesional corticosteroids are referred to as gold standard treatments for keloids. Recent studies showed that ablative fractional laser (AFL) treatment facilitates delivery of topical drug deeply into the skin by creating vertical channels. The objective of the present study was to assess the ablative erbium laser in fractionated mode, combined with topical high potent corticosteroid cream for treating resistant keloid scars. We conducted a retrospective study in the laser center of the Department of Dermatology (University Hospital of Nice, France), from January 2010 to June 2012, on patients with keloids who were resistant to a first-line of treatment. A 2940-nm ablative fractional erbium laser was used. Topical betamethasone cream was applied twice a day under occlusion with transparent film dressings. A total of 23 patients with 70 keloids were treated from January 2010 to June 2012. The median percentage of improvement was 50% (range -43 to 84). The mean follow-up was 8 months (range 3-18), and a recurrence was observed for eight lesions (22%). Although this observation warrants a prospective comparative evaluation, it supports the interest of the laser-assisted delivery of steroids for treating keloids scars.
authors.affiliation: Department of Dermatology, University Hospital of Nice, Nice, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Cavalié
authors.forename: Laura
authors.initials: L
authors.lastname: Sillard
authors.forename: Henri
authors.initials: H
authors.lastname: Montaudié
authors.forename: Philippe
authors.initials: P
authors.lastname: Bahadoran
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lacour
authors.forename: Thierry
authors.initials: T
authors.lastname: Passeron
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D001623:Betamethasone / Q000008:administration & dosage*; D002648:Child; D016503:Drug Delivery Systems / Q000295:instrumentation*; D005260:Female; D005602:France; D005938:Glucocorticoids / Q000008:administration & dosage*; D006785:Hospitals, University; D006801:Humans; D007627:Keloid / Q000175:diagnosis / Q000188:drug therapy*; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D001623:Betamethasone
keywords: ablative fractional laser; keloid treatment; laser-assisted drug delivery; topical corticosteroids; transepidermal drug delivery