• Sonuç bulunamadı

Management of Keloid By Hirudo Therapy Arsheed Iqbal, MD, Huma Haider, MD, Arjumand Shah, MD, Zahood Ahmad, MD, Naquibul Islam, MD

N/A
N/A
Info
İndir
Protected

Academic year: 2021

Share "Management of Keloid By Hirudo Therapy Arsheed Iqbal, MD, Huma Haider, MD, Arjumand Shah, MD, Zahood Ahmad, MD, Naquibul Islam, MD"

Copied!
3
0
0

Yükleniyor.... (view fulltext now)

Şimdi indir ( 3 sayfa )

Tam metin

(1)

Management of Keloid By Hirudo Therapy

Arsheed Iqbal, MD, Huma Haider, MD, Arjumand Shah, MD, Zahood Ahmad, MD, Naquibul Islam, MD

Address: RRIUM, Naseem Bagh Campus, Kashmir University-190006, Srinagar E-mail: iarsheed@yahoo.com

* Corresponding Author: Dr. Arsheed Iqbal, RRIUM, Naseem Bagh Campus, Kashmir University -190006, Srinagar

Case Report DOI: 10.6003/jtad.16101c3

Published:

J Turk Acad Dermatol 2016; 10 (1): 16101c3

This article is available from: http://www.jtad.org/2016/1/jtad16101c3.pdf Keywords: Keloid, hirduo therapy, bioactivity substances

Abstract

Observation: According to Greek classical books leech therapy is the best way to overcome chronic inflammatory conditions. It has been proved that intervention causes reduction in oedema, pain and conjunction. Keloid were described by Egyptian surgeons around 1700BC. Alibert called the keloid first cancroid and later cheloide. Keloid usually grown beyond the borders of the original wound in claw-like growths and can develop after acne, body piercings, burns, laceration, surgical wounds etc. The aim of present study was to assess the effect of leech therapy in resolving the Keloid without surgical intervention and to avoid the scar formation and recurrence. The present study has been conducted at RRIUM, Srinagar to evaluate the keloid resolving activity by the bioactive substances present in the leech saliva. The study has proved very effective by giving the Hirduo therapy to a young female patient with post traumatic keloid above the knee joint, The keloid was completely resolved and there was no recurrence even after one year of post leech therapy follow ups.

Introduction

Keloid were described by Egyptian surgeons around 1700 BC. Boron Gean-Louis Alibert identified the keloid as an entity in 1806.

Change in the cellular signal that control growth and proliferation leads to keloid for- mation [1, 2, 3, 4]. Keloid usually grows be- yond the borders of original wound usually develops after acne, boils, body piercing, burns ,laceration and surgical wound. It ex- pands claw- like growth over normal skin [2].

They are more commonly seen in central chest, back, shoulders, ear lobules, arm,pel- vic region and collar bone. Keloid effects both sexes equally. The incidence in young females is more than young males and is more com- mon in dark skinned people especially Afri- can races and shows genetic trait transmitted by mother or father with the children having 50 % possibility of developing a keloid scar

Page 1 of 3

(page number not for citation purposes) Figure 1.Patient of keloid at entry level

(2)

[5]. In certain syndromes like Rubinstein-

Taybi and Goeninne, it has been found that

there is increased incidence of Keloid forma- tion. Keloid may develop from pseudofollicu- litis barbae, razor bumps and is also speculated to be hereditary. It is estimated that up to 4.5 % of general population suffer from hypertrophic scarring (2JCT). The inci- dence is 15 % higher in high pigmented pe- ople. People of any age can develop and children under ten are less likely to develop Keloid.

Case Report

A 30 year old female patient came with keloid on her right leg above the knee joint. She had taken different treatment but no improvement was ob- served. Leeching was done after undergoing cer- tain investigations including BT, CT, Hb, blood suger to rule out any pathology. After this scree- ning leeching was done on day one. Leeches were applied to the site under all aseptic conditions. Le- eches were allowed to suck on the keloid lesion till they get belly filled and fall of their own. After detaching of leeches antiseptic bandaging was done. Four sittings of leeching were done after every twenty days.

Figure 1 depicts the patient with keloid at the time of clinical examination and registration. Fi- gure 2depicts the sting of leech application. After the first follow up that is after twenty days the ke- loid lesion starts regressing and on the same day second sting of leeching was done. After comple- ting third and fourth sting of leeching the keloid was fully vanished and after one week the scar mark also disappeared which is shown in Figure 3.After completing the treatment (leech therapy) the patient was followed up monthly for a period

of one year and it was observed that the keloid did not recure.

Discussion

Keloids are fibrotic tumors characterized by aty- pical fibroblasts with excessive deposition of ext- racellular matrix components. It can cause significant pain, pruritis and most importantly physical disfigurement. Different treatment are available for keloid like surgery, radiotherapy, cryotherapy, steroids, laser therapy, interferon therapy, pulsed dye lamp treatment, use of selecon gel, retinoids, cytotoxic medicine etc [5, 6, 7, 8] (JCS). The above said modatilities of treatment has side effects like telangiectasias (steroids), thinning of surrounding skin (steroids), cancer (radio the- rapy), paleness of skin (cryotherapy), pain in the scar (cytotoxic medicine). Keeping in view the side effects and the chance of recurrence and ulcera- tion it has been decided to use hirudo therapy as an alternative treatment for the treatment of the Keloid. In this case the patient was given four stings of leech therapy every after twenty days and was followed up monthly for a period of one year.

It has been observed that three and half centime- ter long and one centimeter thick keloid was com- pletely resolved and there was also no scar formation.

References

1. Köse O, Waseem A. Keloids and hypertrophic scars:

are they two different sides of the same coin? Derma- tol Surg 2008, 34: 336-346. PMID: 18177398 2. Atiyeh BS. Nonsurgical management of hypertrophic

scars: evidence-based therapies, standard practices, and emerging methods. Aesthetic Plast Surg 2007, 31: 468-492. PMID: 17576505

3. Atiyeh BS, Costagliola M, Hayek SN. Keloid or hypert- rophic scar: the controversy: review of the literature.

Ann Plast Surg 2005, 54: 676-680. PMID: 15900161 J Turk Acad Dermatol 2016; 10 (1): 16101c3. http://www.jtad.org/2016/1/jtad16101c3.pdf

Page 2 of 3

(page number not for citation purposes) Figure 2.The sting of leech application Figure 3. After completing the treatment healing of

the lesion

(3)

4. Saray Y, Gulec A. Treatment of keloids and hypert- rophic scars with dermojet injections of bleomycin: a preliminary study. Int J Dermatol 2005, 44: 777-784.

PMID: 16135153

5. Al-Attar A, Mess S, Thomassen JM, Kauffman CL, Davison SP. Keloid pathogenesis and treatment. Plast Reconstr Surg 2006, 117: 286-300. PMID: 16404281

6. Alster TS, Tanzi EL. Hypertrophic scars and keloids:

etiology and management. Am J Clin Dermatol 2003, 4: 235-243. PMID: 12680802

7. Mofofikyo BO, Adeyemo WL, Abdus-salam AA. Keloid and hypertrophic scars: a review of recent develop- ments in pathogenesis and management. Nig Q J Hosp Med 2007, 17: 134-139. PMID: 18320758 8. Nig Q J Hosp Med 2007, 17: 134-139. PMID:

18320758

Page 3 of 3

(page number not for citation purposes) J Turk Acad Dermatol 2016; 10 (1): 16101c3. http://www.jtad.org/2016/1/jtad16101c3.pdf

Referanslar

Şimdi indir ( PDF - 3 sayfa - 184.27 KB )

Benzer Belgeler

Behçet’s Disease After H1N1 Vaccination Serap Güneş Bilgili*, MD, Necmettin Akdeniz**, MD, İbrahim Halil Yavuz***, MD, İlhan Çeçen**, MD, Ömer Çalka**, MD

Our patient is the first case in the literature showing the association of Behçet's disease and H1N1 vaccination while there is only one case reported to be triggered with

Erythematous Annular Cicatricial Plaques on the FaceBengü Gerçeker Türk*, MD, Meltem Türkmen*, MD, Gülşen Kandiloğlu**, MD,Derya Dirim Erdoğan***, MD, Tuğrul Dereli*, MD

Background: Lupoid leishmaniasis (LL) is an unusual chronic form of cutaneous leishmaniasis with clinical and histopathological features resembling lupus vulgaris.. It is estimated

Cutaneous Mastocytosis Zekayi Kutlubay*, MD, Gürkan Yardımcı, MD, Burhan Engin, MD, Yalçın Tüzün, MD

Here, cutaneous mastocytosis are divided into three different main subtypes, but telangiectasia macularis eruptiva pers- tans (TMEP) is classified as a special form of

Vitiligo and Oxidative StressZekayi Kutlubay, MD, Tuğba Kevser Uzunçakmak, MD, Burhan Engin, MD, Yalçın Tüzün, MD

In vitiligo oxida- tive stress and accumulation of free radicals in the epidermal layer of affected skin have been shown to be involved areas.. To prove the effect of these species

Alopecia Universalis in a Girl with Down’s SyndromeSumit Sen*, MD, Debabrata Bandyopadhyay**, MD,Gobindo Chatterjee*, MD, Gautam Saha**, MD

We report this case as it is a rare presentation of alopecia universalis in Down’s syndrome with no family history of AA and satisfactory response to

Giant Congenital Melanocytic Nevus on the Back Husein Husein-ElAhmed H, MD, Macías-Jimenez JP, MD, Ruiz-Carrascosa JC, MD

In our patient, although the psychosocial impact of giant nevi was considerable, the lack of dermatoscopic ma- lignant signs as well as the cosmetic issues related of the huge size

A Child with NeumannType Pemphigus VegetansFiliz Canpolat,* MD, Havva Kaya, MD, Fatma Eskioğlu, MD

Pemphigus vegetans is considered to be a rare variant of pemphigus and characterised by blisters and erosions associated with ver- rucous vegetations [6].. Pemphigus vegetans has

Lithium and Psoriasis Yalçın Tüzün, MD, Gürkan Yardımcı,* MD

Ockenfels et al showed that lithium effects the cellular communications of psoriatic ke- ratinocytes when cultured with HUT-78 lymphocytes by triggering the secretion of TGF- α,