Application of mitomycin-c for head and neck keloids

Abstract

Objectives: Keloids of the head and neck are a relatively common entity in darkly pigmented individuals, occurring in 5%-15% of skin wounds. Despite a wide range of available treatments, recurrence rates remain high. This study reviews the effectiveness of using a combination of surgical excision and topical mitomycin c (a chemotherapeutic agent that inhibits fibroblast proliferation) for the treatment of head and neck keloids. Methods: Ten consecutive patients, treated by the same surgeon, underwent the combination of surgical excision of keloids and the application of topical mitomycin-C. The patients were all evaluated preoperatively and were then followed long-term (6–14 months) for recurrence. Results: The combination of surgical excision with the application of topical mitomycin C was highly effective in treating head and neck keloids in this study. There were 9 of 10 patients who had successful excision of the keloid lesions with no recurrence, for a success rate of 90%. One of the 10 patients treated with surgical excision and topical mitomycin-C had a recurrence. Conclusions: The successful treatment of keloids continues to be a challenging endeavor as there is a high propensity for recurrence of this disease process. There have been many reports on various therapies in the literature and success rates are highly variable. In this series of patients, the combination of surgical excision and topical mitomycin C was 90% successful. These are promising results for an alternative treatment option in the management of head and neck keloids.