Cicatrizes hipertroficas e queloides: tratamento com cirurgia e infiltracao de methotrexate - estudo piloto

Introduction: Several therapeutic modalities have been used to treat keloids and hypertrophic scars. Objective: Treatment of keloids and hypertrophic scars with excision and intralesional injection of methotrexate. Methods: Therapeutic intervention open study with 11 patients. Laboratory tests and photographs were carried out before, during, and after the treatment. From the seventh day after the excision of the lesions, the suture was injected weekly with methotrexate for six months. The weekly dose was 2.5 mg / 10cm suture, with a maximum dose of 5mg per patient. The evaluation was carried out by the physician and the patient. Results: Six months after the end of the treatment, there was no recurrence of the lesion in five cases, partial recurrence in six cases and an absence of cases with total recurrence. No alterations were observed in the laboratory tests. Conclusions: The maximum weekly dose of 5mg methotrexate for six months used in this pilot study to treat keloids and hypertrophic scars is safe and hinders recurrence. Further studies are needed to complement the present paper. Introducao: Varias modalidades terapeuticas tem sido utilizadas para o tratamentos de queloides e cicatrizes hipertroficas. Objetivo: Tratamento de queloides e cicatrizes hipertroficas com excisao e injecao intralesional de methotrexate. Metodos: Neste estudo aberto de intervencao terapeutica 11 pacientes foram tratados. Exames laboratoriais e fotos foram realizados antes, durante e apos tratamento. Apos a excisao das lesoes, a sutura foi infiltrada com methotrexate a partir do setimo dia, semanalmente, durante seis meses. A dose semanal foi de 2,5mg/10cm de sutura, e a dose maxima de 5mg por individuo. A avaliacao foi feita pelo medico e pelo paciente. Resultados: Seis meses apos o termino do tratamento, nao ocorreu recidiva da lesao em cinco casos, houve recidiva parcial em seis casos e nenhuma recidiva total. Nao houve alteracao dos exames laboratoriais. Conclusoes: A dose maxima semanal de 5mg de methotrexate durante seis meses utilizada neste estudo-piloto para tratamento de queloides e cicatrizes hipertroficas e segura e dificulta a recidiva. Sao necessarios mais estudos para complementar este trabalho.