Woo Il Kim1, Sooyoung Kim1, Sung Woo Cho2, Moon Kyun Cho1. 1. Department of Dermatology, Soonchunhyang University Hospital, Seoul, Korea. 2. Department of Surgery, Soonchunhyang University Hospital, Seoul, Korea.
Abstract
BACKGROUND: Pathologic scars can lead to itching, erythema, and psychological stress due to cosmetic problems. Bleomycin, one of anticancer agents, has been used for treating keloid or hypertrophic scar. Some studies have shown that bleomycin can induce markedly scar improvement. AIMS: To evaluate the efficacy of bleomycin compared to corticosteroid as well as other treatments for keloid or hypertrophic scar using meta-analysis methods. METHODS: A computerized search was performed in different databases including Cochrane, Embase, and PubMed. Three randomized controlled trials (RCTs) and two controlled clinical trials (CCTs) were included. Then, statistical analyses of extracted outcome data from the studies were calculated using Rex (version 3.0.1; RexSoft Inc). RESULTS: Scar improvement was significantly increased in the bleomycin group compared to the triamcinolone acetonide (TAC) group (SMD: 0.59, 95% CI: 0.30-0.88, P < .0001). In addition, there was also statistically significant difference between the bleomycin group and the 5-FU group (SMD: 1.37, 95% CI: 0.88-1.85, P < .0001). Bleomycin increased relatively scar improvement compared to TAC combined with 5-FU, although there was no statistical difference (SMD: 0.63, 95% CI: -0.59-1.84, P = .3108). Furthermore, bleomycin demonstrated significantly increased improvement of scar compared to TAC combined with cryotherapy (SMD: 1.11, 95% CI: 0.48-1.74, P = .0006). CONCLUSIONS: This meta-analysis found that bleomycin was more effective for treating keloid or hypertrophic scar than other treatments including TAC, 5-FU, TAC combined with 5-FU, and TAC combined with cryotherapy. However, further comprehensive studies, including randomized controlled trials, are needed to perform objective analysis.
BACKGROUND: Pathologic scars can lead to itching, erythema, and psychological stress due to cosmetic problems. Bleomycin, one of anticancer agents, has been used for treating keloid or hypertrophic scar. Some studies have shown that bleomycin can induce markedly scar improvement. AIMS: To evaluate the efficacy of bleomycin compared to corticosteroid as well as other treatments for keloid or hypertrophic scar using meta-analysis methods. METHODS: A computerized search was performed in different databases including Cochrane, Embase, and PubMed. Three randomized controlled trials (RCTs) and two controlled clinical trials (CCTs) were included. Then, statistical analyses of extracted outcome data from the studies were calculated using Rex (version 3.0.1; RexSoft Inc). RESULTS: Scar improvement was significantly increased in the bleomycin group compared to the triamcinolone acetonide (TAC) group (SMD: 0.59, 95% CI: 0.30-0.88, P < .0001). In addition, there was also statistically significant difference between the bleomycin group and the 5-FU group (SMD: 1.37, 95% CI: 0.88-1.85, P < .0001). Bleomycin increased relatively scar improvement compared to TAC combined with 5-FU, although there was no statistical difference (SMD: 0.63, 95% CI: -0.59-1.84, P = .3108). Furthermore, bleomycin demonstrated significantly increased improvement of scar compared to TAC combined with cryotherapy (SMD: 1.11, 95% CI: 0.48-1.74, P = .0006). CONCLUSIONS: This meta-analysis found that bleomycin was more effective for treating keloid or hypertrophic scar than other treatments including TAC, 5-FU, TAC combined with 5-FU, and TAC combined with cryotherapy. However, further comprehensive studies, including randomized controlled trials, are needed to perform objective analysis.
Authors: Liora Bik; Albert Wolkerstorfer; Vazula Bekkers; Errol P Prens; Merete Haedersdal; Daniel Bonn; Martijn B A van Doorn Journal: Lasers Surg Med Date: 2021-12-21