Evaluation of Intralesional Bleomycin and Triamcinolone Acetonide in the Treatment of Keloids: A Prospective, Randomized, Open-Label, Comparative Study

IF 4.2 4区医学 Q1 DERMATOLOGY

International Journal of Dermatology Pub Date : 2026-10-07 Epub Date: 2026-06-26 DOI:10.1111/ijd.70554

Divya Ravali Bandaru, Nirupama Bhagya Lakshmi Tatavarthi, Dasika Subba Rao, Ramala Amala

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引用次数: 0

Abstract

Background

Keloids are benign fibroproliferative scars resulting from dysregulated wound healing and excessive collagen deposition. Despite the availability of multiple therapeutic options, an optimal treatment strategy remains uncertain.

Methods

This prospective, randomized, open-label comparative study enrolled 136 patients with clinically diagnosed keloids, who were assigned to receive either intralesional bleomycin (Group A, n = 68) or intralesional triamcinolone acetonide (Group B, n = 68). Treatments were administered at 4-week intervals for four sessions, with follow-up conducted 2 months after the final session. Outcomes were assessed using the Vancouver Scar Scale (VSS), and responder rates were defined as ≥ 50%, ≥ 75%, and ≥ 90% reductions in VSS. Secondary outcomes included changes in scar height, surface area, and treatment-related adverse effects.

Results

Bleomycin resulted in a significantly greater mean percentage reduction in VSS than triamcinolone (72.02% vs. 58.10%; p < 0.00001). A higher proportion of patients treated with bleomycin achieved ≥ 75% improvement (36.8%, n = 25/68) than those treated with triamcinolone (14.7%, n = 10/68; p = 0.0027). Improvements in vascularity, pliability, and scar height were also significantly greater in the bleomycin group, with a mean scar height reduced to 0.8 versus 1.9 mm in the triamcinolone group (p = 0.003). The reduction in surface area was comparable between the groups (p = 0.850). Pain (n = 50, 74%) and hyperpigmentation (n = 18, 26%) were more frequently observed with bleomycin, whereas skin atrophy (n = 16, 24%) and telangiectasia (n = 15, 22%) were more common with triamcinolone.

Conclusion

Both therapies were associated with significant clinical improvement; however, bleomycin demonstrated superior efficacy in reducing scar severity and achieving higher response rates. Larger, multicenter, blinded studies with longer follow-up periods are warranted to confirm these findings and evaluate long-term outcomes, including recurrence rates.

Abstract Image

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博来霉素和曲安奈德治疗瘢痕疙瘩的评价：一项前瞻性、随机、开放标签的比较研究。

背景：瘢痕疙瘩是由伤口愈合失调和过多胶原沉积引起的良性纤维增生性疤痕。尽管有多种治疗选择，但最佳治疗策略仍不确定。方法：这项前瞻性、随机、开放标签的比较研究纳入了136例临床诊断为瘢痕疙瘩的患者，他们被分配接受病灶内布来霉素（A组，n = 68）或病灶内曲安奈德（B组，n = 68）。每隔4周进行4次治疗，在最后一次治疗后2个月进行随访。使用温哥华疤痕量表（VSS）评估结果，并将应答率定义为VSS减少≥50%，≥75%和≥90%。次要结局包括疤痕高度、表面积和治疗相关不良反应的变化。结果：博来霉素导致VSS的平均降低百分比明显高于曲安奈酮（72.02% vs. 58.10%）； p结论：两种治疗方法均与显著的临床改善相关，但博来霉素在减轻疤痕严重程度和获得更高的应答率方面表现出更优的疗效。需要更大规模、多中心、更长随访期的盲法研究来证实这些发现，并评估包括复发率在内的长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Dermatology 医学-皮肤病学

CiteScore

4.70

自引率

2.80%

发文量

476

审稿时长

3 months

期刊介绍： Published monthly, the International Journal of Dermatology is specifically designed to provide dermatologists around the world with a regular, up-to-date source of information on all aspects of the diagnosis and management of skin diseases. Accepted articles regularly cover clinical trials; education; morphology; pharmacology and therapeutics; case reports, and reviews. Additional features include tropical medical reports, news, correspondence, proceedings and transactions, and education. The International Journal of Dermatology is guided by a distinguished, international editorial board and emphasizes a global approach to continuing medical education for physicians and other providers of health care with a specific interest in problems relating to the skin.