Efectos clínicos y adversos del láser CO2 en el tratamiento de queloides en el pabellón auricular

• Linda Esmeralda Terán Sarmiento ^[1] ; Evelyn Andrea Moncayo Padilla ^[1] ; Renato Francisco Zambrano Sánchez ^[1] ; Dayan Esthefanía Muñoz Aguirre ^[1]
  1. [1] Servicio de Dermatología, Centro Quirúrgico Láser Visión y Piel, Quito, Ecuador
• Localización: Piel: Formación continua en dermatología, ISSN 0213-9251, Vol. 39, Nº. 3 (Marzo), 2024, págs. 129-134
• Idioma: español
• DOI: 10.1016/j.piel.2023.08.010
• Títulos paralelos:
  • Clinical and adverse effects of CO2 laser in the treatment of auricular keloids
• Enlaces
  • Texto Completo Ejemplar
• Resumen
  • español

    Introducción uno de los sitios más comunes para el desarrollo de queloides son los pabellones auriculares. La etiología no se conoce del todo, hasta el momento se sostiene que es multifactorial. A nivel molecular existe una desregulación de los factores de crecimiento como TGF-β1 y bFGF, los cuales pueden ser modificados con la terapia de láser CO2 que posee dichas propiedades. En la actualidad no contamos con guías para el tratamiento de queloides al ser una enfermedad con alta tasa de recidiva, pobre respuesta al tratamiento y efectos adversos de los mismos. El objetivo de nuestro estudio fue determinar los efectos clínicos y efectos adversos inmediatos y a largo plazo del tratamiento escisional con láser CO2 en queloides del pabellón auricular, con el fin de aportar más información sobre este abordaje.

    Material y métodos se realizó un análisis retrospectivo de historias clínicas y registros fotográficos de 15 pacientes con queloides en el pabellón auricular tratados con láser CO2. Se analizó la respuesta clínica y la intensidad de los efectos adversos posláser con seguimiento de hasta un año.

    Resultados los efectos adversos posteriores a la escisión quirúrgica con láser CO2 fueron leves a moderados, con mayor grado de intensidad durante las primeras semanas, resolviéndose al mes de tratamiento. Durante el seguimiento ningún paciente presentó recidivas; sin embargo, solo 6 pacientes completaron el año de seguimiento.

    Conclusiones el tratamiento con láser CO2 en los queloides del pabellón auricular presenta altas tasas de éxito con riesgos mínimos, sin efectos adversos a largo plazo.

  • English

    Introduction One of the most common sites for the development of keloids is the auricular pinna. The etiology is not completely known, but so far it is thought to be multifactorial. At the molecular level there is a deregulation of growth factors such as TGF-β1 and bFGF, which can be modified with CO2 laser therapy. At present, there are no guidelines for the management of keloids because of its high rate of recurrence, poor response to treatment and adverse effects. The aim of our study was to determine the clinical effects and immediate and long-term adverse effects of excisional CO2 laser treatment in auricular keloids, in order to provide more information on this approach.

    Materials and methods A retrospective analysis of clinical histories and photographic records of 15 patients with auricular keloids treated with CO2 laser was performed. The clinical response and severity of post-laser adverse effects were analyzed with follow-up up to one year.

    Results Adverse effects after surgical excision with CO2 laser were mild to moderate, with a greater degree of severity during the first weeks, resolving after one month of treatment. During follow-up no patient presented recurrence, however, only 6 patients completed the one-year follow-up.

    Conclusions CO2 laser treatment of auricular keloids has high success rates with minimal risk and no long-term adverse effects.

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