Journal of Clinical and Aesthetic Dermatology

AUG 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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thyroid gland, are effectively protected. 2 6 moreover, a consensus statement from the e uropean society for therapeutic Radiology and oncology noted that keloids are an acceptable indication for radiotherapy and placed no age restrictions provided that alternative therapies were ineffective. 2 7 CONCLUSION various radiotherapy modalities including electron beam radiotherapy, superscial and orthovoltage radiotherapy, and brachytherapy are being used after excision for the treatment of keloids. Frequently, postsurgical radiation may be a preferable option, as there is a low risk of recurrence and complications. dermatologists should be aware of the option of radiation therapy for diRcult-to-treat keloids so that a true informed consent can be reached with the patient. REFERENCES 1. Gold mh, Berman B, Clementoni mt, et al. updated international clinical recommendations on scar management: part 1--evaluating the evidence. Dermatol Surg. 2014;40:817–824. 2. mustoe ta, Cooter Rd, Gold mh, et al. international clinical recommendations on scar management. Plast Reconstr Surg. 2002;110:560–571. 3. luo s, Benathan m, Raffoul w, et al. abnormal balance between proliferation and apoptotic cell death in sbroblasts derived from keloid lesions. Plast Reconstr Surg. 2001;107:87–96. 4. lee Ks, Jung JB, Ro yJ, et al. effects of x- irradiation on survival and extracellular matrix gene expression of cultured keloid sbroblasts. J Dermatol Sci. 1994;8:33–37. 5. Ji J, tian y, Zhu yQ, et al. ionizing irradiation inhibits keloid sbroblast cell proliferation and induces premature cellular senescence. J Dermatol. 2015;42:56–63. 6. Klumpar di, murray JC, anscher m. Keloids treated with excision followed by radiation therapy. J Am Acad Dermatol. 1994;31:225–231. 7. Cognetta aB Jr, mendenhall wm. Radiation Therapy for Skin Cancer. 1st ed. new york, ny: springer; 2013. 8. miller Ra, spittle mF. electron beam therapy for diRcult cutaneous basal and squamous cell carcinoma. Br J Dermatol. 1982;106:429–435. 9. ogawa R, mitsuhashi K, hyakusoku h, miyashita t. postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Plast Reconstr Surg. 2003;111:547–553. 10. ogawa R, miyashita t, hyakusoku h, et al. postoperative radiation protocol for keloids and hypertrophic scars: statistical analysis of 370 sites followed for over 18 months. Ann Plast Surg. 2007;59:688–691. 11. song C, wu hG, Chang h, et al. adjuvant single- fraction radiotherapy is safe and eQective for intractable keloids. J Radiat Res. 2014;55:912–916. 12. ogawa R, akaishi s, dohi t, et al. analysis of the surgical treatments of 63 keloids on the cartilaginous part of the auricle: eQectiveness of the core excision method. Plast Reconstr Surg. 2015;135:868–875. 13. wang lZ, ding Jp, yang my, Chen B. Forty-sve cases of chest keloids treated with subcutaneous super-tension-reduction suture combined with postoperative electron-beam irradiation. Dermatol Surg. 2014;40:1378–1384. 14. Kim K, son d, Kim J. Radiation therapy following total keloidectomy: a retrospective study over 11 years. Arch Plast Surg. 2015;42:588–595. 15. shen J, lian X, sun y, et al. hypofractionated electron-beam radiation therapy for keloids: retrospective study of 568 cases with 834 lesions. J Radiat Res. 2015;56:811–817. 16. Ragoowansi R, Cornes pG, moss al, Glees Jp. treatment of keloids by surgical excision and immediate postoperative single-fraction radiotherapy. Plast Reconstr Surg. 2003;111:1853–1859. 17. sakamoto t, oya n, shibuya K, et al. dose- response relationship and dose optimization in radiotherapy of postoperative keloids. Radiother Oncol. 2009;91:271–276. 18. emad m, omidvari s, dastgheib l, et al. surgical excision and immediate postoperative radiotherapy versus cryotherapy and intralesional steroids in the management of keloids: a prospective clinical trial. Med Princ Pract. 2010;19:402–405. 19. speranza G, sultanem K, muanza t. descriptive study of patients receiving excision and radiotherapy for keloids. Int J Radiat Oncol Biol Phys. 2008;71:1465–1469. 20. alam m, nanda s, mittal BB, et al. the use of brachytherapy in the treatment of nonmelanoma skin cancer: a review. J Am Acad Dermatol. 2011;65:377–388. 21. williamson JF, Brenner dJ. physics and biology of brachytherapy. in: halperin eC, perez Ca, Brady lw, eds. Perez and Brady's Principles and Practice of Radiation Oncology. 5th ed. philadelphia, pa: lippincott, williams & wilkins; 2008:423–475. 22. Guix B, henríquez i, andrés a, et al. treatment of keloids by high-dose-rate brachytherapy: a seven-year study. Int J Radiat Oncol Biol Phys. 2001;50:167–172. 23. van leeuwen mC, stokmans sC, Bulstra ae, et al. high-dose-rate brachytherapy for the treatment of recalcitrant keloids: a unique, eQective treatment protocol. Plast Reconstr Surg. 2014;134:527–534. 24. arnault Jp, peiQert d, latarche C, et al. Keloids treated with postoperative iridium 192* brachytherapy: a retrospective study. J Eur Acad Dermatol Venereol. 2009;23:807–813. 25. Kuribayashi s, miyashita t, ozawa y, et al. post- keloidectomy irradiation using high-dose-rate superscial brachytherapy. J Radiat Res. 2011;52:365–368. 26. ogawa R, yoshitatsu s, yoshida K, miyashita t. is radiation therapy for keloids acceptable? the risk of radiation-induced carcinogenesis. Plast Reconstr Surg. 2009;124:1196–1201. 27. leer Jw, van houtte p, seegenschmiedt h. Radiotherapy of non-malignant disorders: where do we stand? Radiother Oncol. 2007;83:175–177. JCAD 15 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY august 2017 • volume 10 • number 8 R e v i e w

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