Application of topical mitomycin C to the base of shave-removed keloid scars to prevent their recurrence

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Abstract
Background Keloid scars are formed by over-activity of fibroblasts producing collagen and they cause significant morbidity both from their appearance and from their symptoms. Existing treatments are often unsatisfactory. Topical mitomycin C is known to inhibit fibroblast proliferation. Objectives To determine whether application of mitomycin C to the base of shave-removed keloids would prevent their recurrence. Methods Ten patients had all or part of their keloid shave-removed. After haemostasis topical mitomycin C 1 mg mL−1 was applied for 3 min. This application was repeated after 3 weeks. The keloids were photographed before treatment and the patients were reviewed every 2 months for a total of 6 months when a final photograph of the keloid site was taken. The patients and the Clinical Trials Unit staff scored the outcome on a linear analogue scale of 0–10, where 0 = disappointed and 10 = delighted. The pretreatment and 6-month post-treatment photographs were also assessed by two dermatologists who were not involved in the clinical trial. Results Four of the 10 patients were delighted with the outcome of treatment and only one was disappointed. On average there was an 80% satisfied outcome. Conclusions This new treatment of keloids has been shown to be effective in the majority of patients but further studies are required to confirm this benefit.