Objectives: The objective of this study was to evaluate the immediate (3 months) and long-term (24 months) efficacy of intralesional bleomycin injections (BIL) for the treatment of keloids and to estimate their tolerance.
Introduction: Keloids are a pathological healing process usually occurring after skin trauma, sometimes minor. Despite their benign nature, keloids can have significant repercussions on the quality of life of patients. The treatments vary in effectiveness and are rarely satisfactory. The literature is poor in therapeutic trials or retrospective series.
Bleomycin is a chemotherapeutic agent in the family of cytotoxic antibiotics.The few published studies to assess the efficacy and safety of bleomycin in keloids involved small samples of patients followed on short periods.
Materials / method: This retrospective, monocentric study (CHU of Reims), was conducted from January 2008 to December 2015, included all patients with keloid treated with BIL, with a minimum follow-up of 3 months after the last injection. Injections were performed by the same operator (10mL bleomycin ; concentration 1.5 IU/mL). The number of injections was adapted to the clinical response. Main outcome was the reduction of keloid size classified as: complete (100%), partial major (75% -100%), partial minor (50% -75%) and insufficient (<50%).
Results: Among 70 patients, 66 have been analyzed. This treatment required an average of 3.4 ± 1.3 injections per keloid. The efficacy of a 3 months-lasting treatment, evaluated among 57 patients, was greater than 75% for two thirds of the patients and completed for 40% of them. At 24 months, the evaluation was concerning 44 patients, 52% of them had a keloid decrease of more than 75% and for 30% of them, the recession was complete. Nine recurrences were observed among 50 patients (recurrence rate of 18%) over a follow-up period of 24.8 ± 10.5 months. No systemic complications have been occured.
Conclusion: Our study shows the short-term and long-term efficacy and safety of BIL in the treatment of keloids.
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