Bleomycin and lidocaine delivered via needle-free EPI viable treatment of recalcitrant keloids

Key findings from the research are:

· Fifteen included patients had >148 recalcitrant keloids.

· At baseline, the median total POSAS physician- and patient scores were 40 and 41, respectively. It was reduced by 7 and 6 points at follow-up.

· The median pain scores during EPI-assisted injections were lower than CNI-assistant injections, with 2.5 vs. 7.0, respectively.

· There were mild adverse effects.

· Patients were "satisfied" or "very satisfied" with the treatments.

· In one case, GAIS was "very improved", "improved" in nine patients and "unaltered" in four patients.

· Hyperpigmentation at the site of injection was a common adverse effect.

Concluding further, they said that EPI-assisted treatment with bleomycin and lidocaine is an effective, well-tolerated, patient-friendly alternative for CNI in patients with recalcitrant keloid scars. Further investigations are warranted to add more confirmation and improvement.

In our clinic, for safety reasons, patients are treated with a bleomycin and lidocaine solution of 1 USPE/mL, with a maximum dose of 3 mL, they said.

A real-world setting and a patient-oriented approach were the major strengths of this study.

Study limitations include lack of a control group, short duration of follow-up, limited sample size of 15 patients.

Reference:

Bekkers, V. Z. et al. Needle‐free electronically‐controlled jet injector treatment with bleomycin and lidocaine is effective and well‐tolerated in patients with recalcitrant keloids. Lasers in Surgery and Medicine. https://doi.org/10.1002/lsm.23737