Efficacy of Compound Betamethasone combined with CO2 lattice laser and PDL in treatment of keloid
LI Yan1, XU Xuebing1, KANG Hejun3, TANG Yifu1, SHI Changqian2
1. Department of Burns, Liaoning Provincial Corps Hospitalof Chinese People’s Armed Police Force,Shenyang 110034,China; 2. Department of Psychology, Liaoning Provincial Corps Hospitalof Chinese People’s Armed Police Force,Shenyang 110034,China; 3. Pharmacy, Liaoning Provincial Corps Hospitalof Chinese People’s Armed Police Force,Shenyang 110034,China
Abstract:Objective To observe and analyze the clinical efficacy of Compound Betamethasone (Debaosong) combined with CO2 lattice laser and PDL laser in the treatment of keloid.Methods A total of 111 patients with keloid treated in our department from April 2018 to December 2019 were randomly divided into group A, group B and group C,with 37 patients in each group. Group A was treated with CO2 dot array laser +PDL laser, group B was treated with CO2 dot array laser + Debaosong, and group C was treated with Debaosong combined with CO2 dot array laser +PDL laser every 4 weeks(a course of treatment) for 3 courses. All patients were observed within six months of treatment, and the changes of scar score (VSS), transforming growth factor β1(TGF-β1), matrix metalloproteinase-9(MMP-9) expression levels, clinical efficacy, adverse reactions and recurrence rate were observed before and after treatment in the three groups.Results After 6 months of treatment, the color, vascular distribution, scar softness, thickness and VSS scores of the three groups significantly decreased, and group C was significantly better than group A and B (P<0.05), but there was no statistical difference between group B and group C (P>0.05). The total effective rate of group A, B and C was 86.49%, 83.78% and 94.60%, respectively. The curative effect of group C was significantly better than that of group A and B (P<0.05). After 1 month of treatment, the expression levels of TGF-β1 and MMP-9 in the three groups were significantly improved (P<0.05).The expression levels of TGF-β1 and MMP-9 in group C were significantly lower than those in groups A and B (P<0.05),while there was no statistical difference between group A and B.At the end of the first month after treatment, 2 patients in Group A showed partial pigmentation in the treated area of keloid, and 3 patients in Group B showed redness and abundant blood vessels. No pain, hematoma, pruritus, skin infection, pigmentation and skin atrophy or other adverse reactions were found in the other patients, and no recurrence was observed. At the end of the 6th months, the adverse reactions such as pigmentation and color redness were basically subsided, but partial keloid appeared in all the three groups, and the recurrence rates were 8.11% (3 cases, group A), 5.41% (2 cases, group B) and 2.70% (1 case, group C) (χ2=0.24, P=0.98)respectively.Conclusions Debaosong combined with CO2 dot-matrix laser and PDL in the treatment of keloid is characterized by definite efficacy, high safety, low recurrence rate, and can effectively promote the recovery of scar tissues, which is worthy of clinical promotion.
李妍, 胥学冰, 康贺军, 唐亦复, 史昌乾. 复方倍他米松联合CO2点阵激光、PDL激光治疗瘢痕疙瘩疗效分析[J]. 武警医学, 2022, 33(7): 618-622.
LI Yan, XU Xuebing, KANG Hejun, TANG Yifu, SHI Changqian. Efficacy of Compound Betamethasone combined with CO2 lattice laser and PDL in treatment of keloid. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(7): 618-622.
Boccara D,Serror K,Chatelain S,et al. A new therapeutic protocol for the treatment of keloid scars:a retrospective study[J]. J Wound Care,2021,30(3):184-190.
[2]
Hassan H S,Masenga E J. Quality of life of patients with keloid at the regional dermatology training centre,Northern Tanzania[J]. Dermatol Rev,2020,1(5):173-176.
Abd E,Shady M,Muhammad M. Pulsed dye laser versus long-pulsed Nd:YAG laser in the treatment of hypertrophic scars and keloid:a comparative randomized split-scar trial[J].J Cosmet Laser Ther,2016,18(4):208-212.
Mahar P D,Spinks A B,Cleland H,et al. Improvement of burn scars treated with fractional ablative CO2 lasers-a systematic review and meta-analysis using the vancouver scar scale[J]. Burn Care Res,2021,42(2):200-206.
Ouyang H W,Li G F, Lei Y,et al. Comparison of the effectiveness of pulsed dye laser vs pulsed dye laser combined with ultrapulse fractional CO2 laser in the treatment of immature red hypertrophic scars[J]. Cosmet Dermatol, 2018,17(1):54-60.