![]() ![]() They can expect it to be flatter, less itchy or symptomatic, but it is unlikely that it will look perfect,” he said. “Aesthetically, one of the things that I let patients know is the keloid will never look like regular, normal skin. Treatment results in improvement but not perfection. ![]() “By using PPE, especially gloves, facemasks, and eye protection, it helps keeps us safe while providing the best care to our patients.” Pearl 4: Set patient expectationsĭermatologists should let keloid patients know they likely will need multiple treatments-usually at least 4 to 6 to improve the keloid dramatically. When you inject the anti-keloid medication, the medication can spray back onto the injector,” Dr. “There is a lot of pressure within the keloid. Most dermatologists are using PPE during the COVID-19 pandemic, but there is another reason to wear PPE when injecting keloids. Pearl 3: Use personal protective equipment (PPE) while injecting keloids The larger gauge makes it easier for medication to enter the keloid and helps improve comprehensive keloid treatment. Jagdeo typically recommends using a 25-gauge or 22-gauge needle. Pearl 2: Use a large-gauge needle for keloid injectionsĭermatologists often use a small 30-gauge needle to inject keloids. Cryotherapy softens the keloid and makes it more amenable to treatment injections. Jagdeo sprays a diffuse stream of liquid nitrogen to gently freeze the keloid, waits about 30 seconds to allow the keloid to thaw, then repeats the process before injecting the scar. ![]() Charles McDonald, who was the founding chairman of Brown Medical School Department of Dermatology, is to gently paint the keloid with cryotherapy, or liquid nitrogen,” Dr. “One of the pearls that I learned from Dr. ![]() One of the challenges with treating keloids is they are firm, making it difficult to inject them. Pearl 1: Use cryotherapy before intralesional Kenalog injection (ILK) Jagdeo presented on keloid management in September at the virtual Skin of Color Update 2020, offering pearls and his take on promising therapies in the pipeline. These findings suggest that pirfenidone suppresses the contraction of keloid-derived fibroblasts by inhibiting the down-stream pathway of TGF-β1, thus demonstrating its therapeutic utility for the treatment of keloid lesions.Dr. TGF-β1 stimulated mRNA expression of TGFB1, CTGF, aSMA, and Col1A1 in keloid fibroblasts, while pirfenidone significantly inhibited mRNA expression of CTGF and aSMA in the identical cells. Pirfenidone suppressed gel contraction with TGF-β1 dose dependently. The contractility of keloid fibroblast-embedded collagen gel was increased after the addition of TGF-β1. Real time RT-PCR was performed to detect mRNA expression of TGFB1, CTGF, aSMA, and Col1A1 quantitatively in keloid fibroblasts incubated with/without TGF-β1 in the presence or absence of pirfenidone. The gel contractility of a mixture of keloid fibroblasts and an acid-soluble collagen solution was examined with/without transforming growth factor (TGF)-β1 in the presence or absence of pirfenidone. In order to examine whether pirfenidone has a therapeutic effect on keloid lesions, we prepared an in vitro wound contraction model with keloid fibroblasts. Pirfenidone is a novel anti-fibrotic agent that inhibits the progression of fibrosis occurring in the keloid lesions of the lung and kidney. Keloid is a clinically intractable disease that causes disfigurement, itching, and pain due to abnormal proliferation of fibroblasts and production of collagen. ![]()
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