Table 8 Other treatment modalities
From: Keloid treatments: an evidence-based systematic review of recent advances
First author, year | Study design | Treatment | Duration | N | Outcome(s) | Follow-up time | Adverse events | Comments |
|---|---|---|---|---|---|---|---|---|
Berman, 2013 [124] | P | Excision then porcine gelatin-dextran hydrogel scaffold | NA | 19 (26 keloids) | 7.7% recurrence rate, average patient scar satisfaction 9.9/10 | 12 months | None | Earlobe keloids |
Bhusari, 2017 [122] | P | Re-188 custom RT patch | 3 h on weeks 1 and 3 | 12 (85 keloids) | Durable symptomatic relief, scar size, and elevation reduced for all | 12 months | Ulceration, hypopigmentation | No objective measurements reported |
Garakaparthi, 2016 [125] | P | Excision then hydrogel scaffold | NA | 19 (26 keloids) | 19.2% recurrence rate | 12 months | Earlobe keloids | |
Kim, 2020 [120] | RCT | IL TAC and extracorporeal shockwave therapy (ESWT) vs IL TAC alone | 4 sessions of Q3 week IL TAC then ESWT weekly for 10 sessions vs 4 sessions of q3 week IL TAC | 40 | Mean VSS 7.5 to 3.30 vs 6.85 to 4.1 | 12 weeks | Telangiectasia, hypopigmentation, atrophy, crystal formation (no difference between groups) | |
Limthanakul, 2020 [126] | RCT | Excision then IL TAC (10 mg/ml) versus excision then topical 5% imiquimod cream | IL TAC until scar flattened vs qod for 12 weeks | 30 | Recurrence 50% versus 21.43%; no significant difference in VSS or patient satisfaction | > 12 months | Itching with imiquimod | Earlobe keloids |
Salunke, 2014 [127] | RCT | Ksharsutra ligation vs ksharsutra ligation with agnikarma (cauterization) | NA vs agnikarma on day 3 after keloid removal | 20 | 70% vs 10% recurrence | 36 months | Ear pinna keloids, ksharsutra is surgical thread coated with latex of Euphorbia neriifolia and Curcuma longa powder | |
Sigler, 2010 [128] | P | 2-mg colchicine daily then excision | 1 month prior until 1 year after excision | 10 | No recurrence | 2 years | Diarrhea necessitating dose reduction to 1 mg | |
Song, 2018 [129] | RCT | Excision, RT, then hyperbaric oxygen therapy (HBOT) vs excision and RT | 900-cGy RT on days 1 and 7; HBOT 120 min daily for 2 weeks | 240 | 5.97% vs 14.15% recurrence (p < 0.5), 88.81% vs 75.47% fully cured | Median 20.5 vs 21 months | Not stated | |
Tan, 2018 [121] | SB, P, intraindividual controlled | Drug-free solid microneedle array (MNA) vs no treatment | 4 weeks of treatment | 28 | Transient decrease in volume, no difference in VSS between treated and untreated | 8 weeks | Not stated | 1 patient did not participate; volume decreased after treatment but increased 4 weeks after treatment stopped |
Wang, 2018 [119] | RCT | ESWT vs IL TAC (10 mg/ml) | 3 sessions ESWT in 6 weeks vs IL TAC q2 weeks for 3 sessions | 39 | Reduction in volume, height, appearance without significant difference between treatments | 48 weeks | Not stated | |
Weshay, 2015 [123] | p | 3–4 sessions of RF then IL TAC (10 mg/mL) | IL TAC q3 months for 3 sessions and once after another 6 months | 18 | Volume reduction 95.4% (p = 0.001); 10% recurrence which resolved with IL TAC | 5 years | No infection |