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Erschienen in: HNO 7/2022

30.05.2022 | Keloid | CME

Therapie von Keloiden

verfasst von: Fabienne Oettgen, Frank Haubner

Erschienen in: HNO | Ausgabe 7/2022

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Zusammenfassung

Keloide zählen zu den fibroproliferativen Erkrankungen und präsentieren sich klinisch häufig mit funktionellen und kosmetischen Beeinträchtigungen des Patienten sowie Pruritus und Dolenz. Die Pathogenese von Keloiden ist nicht endgültig geklärt und die Behandlung häufig langwierig und wenig zufriedenstellend. Zur Behandlung von Keloiden steht eine Vielzahl an Therapiemöglichkeiten zur Verfügung, die Evidenzlage ist jedoch aufgrund von Studien mit kleinen Fallzahlen gering. Vielversprechend scheint die Anwendung multimodaler Therapiekonzepte, welche insbesondere in der Behandlung von aurikulären Keloiden gute Resultate zeigen.
Literatur
1.
Zurück zum Zitat Mustoe TA, Cooter RD, Gold MH, Hobbs FD, Ramelet AA, Shakespeare PG et al (2002) International clinical recommendations on scar management. Plast Reconstr Surg 110(2):560–571 CrossRef Mustoe TA, Cooter RD, Gold MH, Hobbs FD, Ramelet AA, Shakespeare PG et al (2002) International clinical recommendations on scar management. Plast Reconstr Surg 110(2):560–571 CrossRef
2.
Zurück zum Zitat Furnas DW (1990) Complications of surgery of the external ear. Clin Plast Surg 17(2):305–318 CrossRef Furnas DW (1990) Complications of surgery of the external ear. Clin Plast Surg 17(2):305–318 CrossRef
3.
Zurück zum Zitat Peacock EE Jr., Madden JW, Trier WC (1970) Biologic basis for the treatment of keloids and hypertrophic scars. South Med J 63(7):755–760 CrossRef Peacock EE Jr., Madden JW, Trier WC (1970) Biologic basis for the treatment of keloids and hypertrophic scars. South Med J 63(7):755–760 CrossRef
4.
Zurück zum Zitat Tredget EE, Nedelec B, Scott PG, Ghahary A (1997) Hypertrophic scars, keloids, and contractures. The cellular and molecular basis for therapy. Surg Clin North Am 77(3):701–730 CrossRef Tredget EE, Nedelec B, Scott PG, Ghahary A (1997) Hypertrophic scars, keloids, and contractures. The cellular and molecular basis for therapy. Surg Clin North Am 77(3):701–730 CrossRef
5.
Zurück zum Zitat Jagadeesan J, Bayat A (2007) Transforming growth factor beta (TGFbeta) and keloid disease. Int J Surg 5(4):278–285 CrossRef Jagadeesan J, Bayat A (2007) Transforming growth factor beta (TGFbeta) and keloid disease. Int J Surg 5(4):278–285 CrossRef
6.
Zurück zum Zitat Oluwasanmi JO (1974) Keloids in the African. Clin Plast Surg 1(1):179–195 CrossRef Oluwasanmi JO (1974) Keloids in the African. Clin Plast Surg 1(1):179–195 CrossRef
7.
Zurück zum Zitat Hackert I, Aschoff R, Sebastian G (2003) The treatment of keloids. Hautarzt 54(10):1003–1015 (quiz 16–7) CrossRef Hackert I, Aschoff R, Sebastian G (2003) The treatment of keloids. Hautarzt 54(10):1003–1015 (quiz 16–7) CrossRef
8.
Zurück zum Zitat Werner S, Krieg T, Smola H (2007) Keratinocyte-fibroblast interactions in wound healing. J Invest Dermatol 127(5):998–1008 CrossRef Werner S, Krieg T, Smola H (2007) Keratinocyte-fibroblast interactions in wound healing. J Invest Dermatol 127(5):998–1008 CrossRef
10.
Zurück zum Zitat Fujiwara M, Muragaki Y, Ooshima A (2005) Upregulation of transforming growth factor-beta1 and vascular endothelial growth factor in cultured keloid fibroblasts: relevance to angiogenic activity. Arch Dermatol Res 297(4):161–169 CrossRef Fujiwara M, Muragaki Y, Ooshima A (2005) Upregulation of transforming growth factor-beta1 and vascular endothelial growth factor in cultured keloid fibroblasts: relevance to angiogenic activity. Arch Dermatol Res 297(4):161–169 CrossRef
11.
Zurück zum Zitat Wang P, Jiang LZ, Xue B (2016) Recombinant human endostatin reduces hypertrophic scar formation in rabbit ear model through down-regulation of VEGF and TIMP‑1. Afr Health Sci 16(2):542–553 CrossRef Wang P, Jiang LZ, Xue B (2016) Recombinant human endostatin reduces hypertrophic scar formation in rabbit ear model through down-regulation of VEGF and TIMP‑1. Afr Health Sci 16(2):542–553 CrossRef
12.
Zurück zum Zitat Sayah DN, Soo C, Shaw WW, Watson J, Messadi D, Longaker MT et al (1999) Downregulation of apoptosis-related genes in keloid tissues. J Surg Res 87(2):209–216 CrossRef Sayah DN, Soo C, Shaw WW, Watson J, Messadi D, Longaker MT et al (1999) Downregulation of apoptosis-related genes in keloid tissues. J Surg Res 87(2):209–216 CrossRef
13.
Zurück zum Zitat Babu M, Diegelmann R, Oliver N (1989) Fibronectin is overproduced by keloid fibroblasts during abnormal wound healing. Mol Cell Biol 9(4):1642–1650 PubMedPubMedCentral Babu M, Diegelmann R, Oliver N (1989) Fibronectin is overproduced by keloid fibroblasts during abnormal wound healing. Mol Cell Biol 9(4):1642–1650 PubMedPubMedCentral
14.
Zurück zum Zitat Cosman B, Wolff M (1972) Correlation of keloid recurrence with completeness of local excision. A negative report. Plast Reconstr Surg 50(2):163–166 CrossRef Cosman B, Wolff M (1972) Correlation of keloid recurrence with completeness of local excision. A negative report. Plast Reconstr Surg 50(2):163–166 CrossRef
15.
Zurück zum Zitat Lee Y, Minn KW, Baek RM, Hong JJ (2001) A new surgical treatment of keloid: keloid core excision. Ann Plast Surg 46(2):135–140 CrossRef Lee Y, Minn KW, Baek RM, Hong JJ (2001) A new surgical treatment of keloid: keloid core excision. Ann Plast Surg 46(2):135–140 CrossRef
16.
Zurück zum Zitat Al-Attar A, Mess S, Thomassen JM, Kauffman CL, Davison SP (2006) Keloid pathogenesis and treatment. Plast Reconstr Surg 117(1):286–300 CrossRef Al-Attar A, Mess S, Thomassen JM, Kauffman CL, Davison SP (2006) Keloid pathogenesis and treatment. Plast Reconstr Surg 117(1):286–300 CrossRef
17.
Zurück zum Zitat Wong VW, Akaishi S, Longaker MT, Gurtner GC (2011) Pushing back: wound mechanotransduction in repair and regeneration. J Invest Dermatol 131(11):2186–2196 CrossRef Wong VW, Akaishi S, Longaker MT, Gurtner GC (2011) Pushing back: wound mechanotransduction in repair and regeneration. J Invest Dermatol 131(11):2186–2196 CrossRef
18.
Zurück zum Zitat Cohen IK, Diegelmann RF, Johnson ML (1977) Effect of corticosteroids on collagen synthesis. Surgery 82(1):15–20 PubMed Cohen IK, Diegelmann RF, Johnson ML (1977) Effect of corticosteroids on collagen synthesis. Surgery 82(1):15–20 PubMed
19.
Zurück zum Zitat Hayashi T, Furukawa H, Oyama A, Funayama E, Saito A, Murao N et al (2012) A new uniform protocol of combined corticosteroid injections and ointment application reduces recurrence rates after surgical keloid/hypertrophic scar excision. Dermatol Surg 38(6):893–897 CrossRef Hayashi T, Furukawa H, Oyama A, Funayama E, Saito A, Murao N et al (2012) A new uniform protocol of combined corticosteroid injections and ointment application reduces recurrence rates after surgical keloid/hypertrophic scar excision. Dermatol Surg 38(6):893–897 CrossRef
20.
Zurück zum Zitat Gupta S, Kalra A (2002) Efficacy and safety of intralesional 5‑fluorouracil in the treatment of keloids. Dermatology 204(2):130–132 CrossRef Gupta S, Kalra A (2002) Efficacy and safety of intralesional 5‑fluorouracil in the treatment of keloids. Dermatology 204(2):130–132 CrossRef
21.
Zurück zum Zitat Bijlard E, Steltenpool S, Niessen FB (2015) Intralesional 5‑fluorouracil in keloid treatment: a systematic review. Acta Derm Venereol 95(7):778–782 PubMed Bijlard E, Steltenpool S, Niessen FB (2015) Intralesional 5‑fluorouracil in keloid treatment: a systematic review. Acta Derm Venereol 95(7):778–782 PubMed
22.
Zurück zum Zitat Reno F, Sabbatini M, Lombardi F, Stella M, Pezzuto C, Magliacani G et al (2003) In vitro mechanical compression induces apoptosis and regulates cytokines release in hypertrophic scars. Wound Repair Regen 11(5):331–336 CrossRef Reno F, Sabbatini M, Lombardi F, Stella M, Pezzuto C, Magliacani G et al (2003) In vitro mechanical compression induces apoptosis and regulates cytokines release in hypertrophic scars. Wound Repair Regen 11(5):331–336 CrossRef
23.
Zurück zum Zitat Akoz T, Gideroglu K, Akan M (2002) Combination of different techniques for the treatment of earlobe keloids. Aesthetic Plast Surg 26(3):184–188 CrossRef Akoz T, Gideroglu K, Akan M (2002) Combination of different techniques for the treatment of earlobe keloids. Aesthetic Plast Surg 26(3):184–188 CrossRef
24.
Zurück zum Zitat Park TH, Seo SW, Kim JK, Chang CH (2011) Outcomes of surgical excision with pressure therapy using magnets and identification of risk factors for recurrent keloids. Plast Reconstr Surg 128(2):431–439 CrossRef Park TH, Seo SW, Kim JK, Chang CH (2011) Outcomes of surgical excision with pressure therapy using magnets and identification of risk factors for recurrent keloids. Plast Reconstr Surg 128(2):431–439 CrossRef
25.
Zurück zum Zitat Bran GM, Brom J, Hormann K, Stuck BA (2012) Auricular keloids: combined therapy with a new pressure device. Arch Facial Plast Surg 14(1):20–26 CrossRef Bran GM, Brom J, Hormann K, Stuck BA (2012) Auricular keloids: combined therapy with a new pressure device. Arch Facial Plast Surg 14(1):20–26 CrossRef
26.
Zurück zum Zitat Thierauf J, Walther M, Rotter N, Scheithauer MO, Hoffmann TK, Veit JA (2017) Treatment of ear keloids: algorithm for a multimodal therapy regimen. Eur Arch Otorhinolaryngol 274(11):3859–3866 CrossRef Thierauf J, Walther M, Rotter N, Scheithauer MO, Hoffmann TK, Veit JA (2017) Treatment of ear keloids: algorithm for a multimodal therapy regimen. Eur Arch Otorhinolaryngol 274(11):3859–3866 CrossRef
27.
Zurück zum Zitat Ogawa R, Mitsuhashi K, Hyakusoku H, Miyashita T (2003) Postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Plast Reconstr Surg 111(2):547–553 (discussion 54–5) PubMed Ogawa R, Mitsuhashi K, Hyakusoku H, Miyashita T (2003) Postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Plast Reconstr Surg 111(2):547–553 (discussion 54–5) PubMed
28.
Zurück zum Zitat Wagner W, Alfrink M, Micke O, Schafer U, Schuller P, Willich N (2000) Results of prophylactic irradiation in patients with resected keloids—a retrospective analysis. Acta Oncol 39(2):217–220 CrossRef Wagner W, Alfrink M, Micke O, Schafer U, Schuller P, Willich N (2000) Results of prophylactic irradiation in patients with resected keloids—a retrospective analysis. Acta Oncol 39(2):217–220 CrossRef
29.
Zurück zum Zitat Gold MH, Berman B, Clementoni MT, Gauglitz GG, Nahai F, Murcia C (2014) Updated international clinical recommendations on scar management: part 1—evaluating the evidence. Dermatol Surg 40(8):817–824 PubMed Gold MH, Berman B, Clementoni MT, Gauglitz GG, Nahai F, Murcia C (2014) Updated international clinical recommendations on scar management: part 1—evaluating the evidence. Dermatol Surg 40(8):817–824 PubMed
30.
Zurück zum Zitat Mirmovich O, Gil T, Goldin I, Lavi I, Mettanes I, Har-Shai Y (2012) Pain evaluation and control during and following the treatment of hypertrophic scars and keloids by contact and intralesional cryosurgery—a preliminary study. J Eur Acad Dermatol Venereol 26(4):440–447 CrossRef Mirmovich O, Gil T, Goldin I, Lavi I, Mettanes I, Har-Shai Y (2012) Pain evaluation and control during and following the treatment of hypertrophic scars and keloids by contact and intralesional cryosurgery—a preliminary study. J Eur Acad Dermatol Venereol 26(4):440–447 CrossRef
31.
Zurück zum Zitat Manuskiatti W, Fitzpatrick RE, Goldman MP (2001) Energy density and numbers of treatment affect response of keloidal and hypertrophic sternotomy scars to the 585-nm flashlamp-pumped pulsed-dye laser. J Am Acad Dermatol 45(4):557–565 CrossRef Manuskiatti W, Fitzpatrick RE, Goldman MP (2001) Energy density and numbers of treatment affect response of keloidal and hypertrophic sternotomy scars to the 585-nm flashlamp-pumped pulsed-dye laser. J Am Acad Dermatol 45(4):557–565 CrossRef
32.
Zurück zum Zitat Alster TS, Nanni CA (1998) Pulsed dye laser treatment of hypertrophic burn scars. Plast Reconstr Surg 102(6):2190–2195 CrossRef Alster TS, Nanni CA (1998) Pulsed dye laser treatment of hypertrophic burn scars. Plast Reconstr Surg 102(6):2190–2195 CrossRef
33.
Zurück zum Zitat Asilian A, Darougheh A, Shariati F (2006) New combination of triamcinolone, 5‑Fluorouracil, and pulsed-dye laser for treatment of keloid and hypertrophic scars. Dermatol Surg 32(7):907–915 PubMed Asilian A, Darougheh A, Shariati F (2006) New combination of triamcinolone, 5‑Fluorouracil, and pulsed-dye laser for treatment of keloid and hypertrophic scars. Dermatol Surg 32(7):907–915 PubMed
34.
Zurück zum Zitat Kwak DH, Bae TH, Kim WS, Kim HK (2016) Anti-vascular endothelial growth factor (bevacizumab) therapy reduces hypertrophic scar formation in a rabbit ear wounding model. Arch Plast Surg 43(6):491–497 CrossRef Kwak DH, Bae TH, Kim WS, Kim HK (2016) Anti-vascular endothelial growth factor (bevacizumab) therapy reduces hypertrophic scar formation in a rabbit ear wounding model. Arch Plast Surg 43(6):491–497 CrossRef
35.
Zurück zum Zitat Wilgus TA (2019) Vascular endothelial growth factor and cutaneous scarring. Adv Wound Care (New Rochelle) 8(12):671–678 CrossRef Wilgus TA (2019) Vascular endothelial growth factor and cutaneous scarring. Adv Wound Care (New Rochelle) 8(12):671–678 CrossRef
Metadaten
Titel
Therapie von Keloiden
verfasst von
Fabienne Oettgen
Frank Haubner
Publikationsdatum
30.05.2022
Verlag
Springer Medizin
Erschienen in
HNO / Ausgabe 7/2022
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-022-01183-9