RT Book, Section
A1 Waldman, Abigail
A1 Alam, Murad
A2 Alam, Murad
A2 Dover, Jeffrey S.
A2 Waibel, Jill S.
A2 Arndt, Kenneth A.
A2 Kim, John Y. S.
A2 Thomas, J. Regan
A2 Gaball, Curtis W.
A2 Chan, Rodney K.
SR Print(0)
ID 1176880336
T1 Antimetabolites and Antimitotic Drugs in the Treatment of Keloid and Hypertrophic Scars
T2 Treatment of Scars From Burns and Trauma
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9780071839914
LK dermatology.mhmedical.com/content.aspx?aid=1176880336
RD 2024/04/25
AB In  addition  to  procedural  interventions,  and  often  in  combination  with  these,  antimetabolite  and  antimitotic  drugs  can  be  used  to  treat  hypertrophic  scars  and  keloids  while  also  mitigating  their  likelihood  of  recurrence.  Such  drugs  can  be  administered  topically,  intralesionally,  or  orally.  Intralesional  5-fluorouracil,  a  pyrimidine  analogue  with  antimetabolite  activity  that  inhibits  fibroblast  proliferation,  is  the  most  common  antimetabolite  agent  for  thickened  scars.  Other  options  include  oral  methotrexate,  an  antimetabolite  (antifolate)  that  prevents  reduction  of  folate  to  its  active  form  by  inhibiting  dihydrofolate  reductase;  intralesional  bleomycin,  a  cytotoxic  antibiotic  derived  from  Streptomyces  verticellus  that  has  been  shown  to  inhibit  collagen  synthesis  and  induce  apoptosis;  oral  colchicine,  an  antimitotic  agent  believed  to  interfere  with  cell  division  through  its  disruptive  action  on  the  mitotic  spindle,  whereby  it  manifests  a  specific  and  dose-dependent  inhibitory  effect  on  collagen  synthesis  and  fibroblast  proliferation;  and  topical  mitomycin  C,  a  cytotoxic  antineoplastic  antibiotic  produced  by  Streptomyces  caespitosus,  with  antiproliferative  effects  on  fibroblasts  through  DNA  synthesis  inhibition.  Notably,  virtually  all  of  these  scar  reduction  treatments,  while  evidence-based,  are  off-label  indications  for  these  drugs.