Botulinic toxin type A in the treatment of keloid

Abstract

Background and objective. When the healing process is disturbed or interrupted, uncontrolled skin repair can occur, such as that observed in keloid. These are recognized as unique fibroproliferative tumors in humans, always representing difficult-to-treat lesions because most therapeutic approaches remain clinically unsatisfactory. However, recent studies have suggested that botulinum toxin type A (BTA) influences apoptosis and cell proliferation. This is why we set out to demonstrate whether intralesional BTA produces improvement not only clinically but also histologically in the keloid. Methods. Eleven keloids were selected and biopsies were performed as well as previous measurements and 3 controls after the application of BTA. Histopathological description of the changes observed 3 months after therapy using the Software Image Pro Plus, version 5.0 (Olympus®) and stains with hematoxylin-eosin (H/E) and Masson's trichomic. Statistical treatment was applied through analysis of demographic and clinical characteristics. The frequency and percentages were determined for the nominal variables, so descriptive tables were made. With the quantitative variables we worked with measures of central tendency (average). For the comparison and analysis of the variables, measures of central tendency (mean), coefficient of Pearson relation and standard deviation were used. Results. The average age was 31 years, the predominant sex was female (63%), the most frequent etiology was posttraumatic (35%), the skin type IV predominated (50%). Clinically there was significant improvement in height and width of the keloid confirmed by Pearson's coefficient of relationship with -0.91 and -0.88 respectively and improvement of pain, pruritus, coloration and consistency, as well as reduction of the diameter of the epidermis verified by standard deviation and changes on the dermis in terms of collagen distribution, vascularization, inflammatory infiltrate and dermo-epidermal junction. Conclusions. Due to the results obtained in our study from the clinical and histopathological point of view, BTA could be considered as a new therapeutic option for the treatment of keloid.