Intralesional Injection of Keloids and Hypertrophic Scars with the ...

Clinical ResultsRelief of symptoms.An analysis of the 4 patients seeking onlyrelief of symptoms proved interesting.1. A 38-year-old woman had had a hysterectomythrough a lower vertical mid-abdominalincision 2 years previously. She developed araised, hypertrophic, reddish brown scarmeasuring 2 in. by 9 in. The scar wasextremely sensitive and painful. She wasunable to wear a girdle or other tight clothingover the scarred area. The entire scar wasinjected with the Dermo-Jet initially, and thepatient had complete relief of symptoms within48 hr. after the injection. The patientsubsequently had 2 additional series ofinjections with complete flattening of the scarand permanent cessation of the symptoms.2. A 70-year-old man had had a colon resectionthrough a lower vertical mid-abdominalincision 10 months previously. He developed araised, painful, hypertrophic, reddish brownscar measuring % in. by9 in. This patient alsohad complete relief of symptoms after theinitial injection. He subsequently had 2additional series of injections with completeflattening of the scar.3. A 42-year-old woman had a similar raisedhypertrophic scar on the right flank resultingfrom a nephrectomy operation 18 monthspreviously. This patient was very apprehensiveand had been under psychiatric care for adepressed state. This scar measured 3/8 in. by8 in. Her symptoms were relieved after 2 seriesof injections. A major portion of her scar wasflattened. This patient was one of a few whocomplained of severe pain during the injectionand also persistent burning pain for severalhours after the injection.4. A 19-year-old girl complained of severe painto pressure over a small localized area ofsubcutaneous scarring on the sole of the leftfoot following removal of a plantar wart 2years previously. This patient had 1 injectionwith the Dermo-Jet. The scar softened andcompletely disappeared with cessation ofsymptoms within a month after treatment.Of the other 10 with symptoms, 9 hadcomplete relief of symptoms within 48 hr. after theinitial series of injections. The remaining patient was a33-year-old woman with multiple hypertrophic scars onthe palm of the left hand resulting from a crush injury 5months previously. She had 5 series of injections withsoftening and leveling of the scars and markedimprovement of symptoms. She still complained ofmoderate pain to pressure over a tight scar on theproximal crease of the palm.Appearance of the scarAnalysis of the appearance of the scars afterinjection indicated a very favorable response to thetherapy. Nine patients are still under treatment. Of theremaining 19 patients, 14 had complete leveling of thekeloid or hypertrophic scars. Of the 14, 4 were smallkeloids averaging 1,4 in. in diameter resulting fromvaccination. The other 10 were hypertrophic scarsresulting from surgery or injury. Of the 5 of the 19 whoshowed incomplete leveling of the scar, 2 had 80 to 90per cent leveling.1. The patient was a 17-year-old girl with a largerecurrent keloid on the left shoulder measuring2½ in. in diameter. It was of 3 years’ durationand resulted from the surgical excision andgraft of another keloid resulting fromvaccination. X-ray therapy was also given atthe time of the surgical excision. She had atotal of 8 series of injections over a period of10 months.2. An 18-year-old boy had a keloid over the leftmastoid area resulting from a car accident. Thescar measured 3/8 in. by 1 in. He had a total of3 series. Three showed a 60 to 75 per centleveling of the scar.3. A 21-year-old man had multiple keloids on hischest resulting from acne. Hehad a total of 7 series of injections.4. A 42-year-old woman had a hypertrophic scaron the right flank following a nephrectomy.She had a total of 2 series of injections.5. A 14-year-old boy had a large keloid on theleft side of the neck resulting from injury. Hehad had a surgical excision with Z-plastyrepair 1 year previously with markedrecurrence of the keloid which measured 1 1/2in. by 5 in. He had a total of 10 series of injectionsover a period of 12 months with about75 per cent flattening of the scar.