Treatment of External Ear Keloids with the Application of Imiquimod 5% Cream after a Parallel Shave Excision

Kim, Tae Yoon; Kim, Dong Hyun; Yoon, Moon Soo

Abstract

BACKGROUND
Keloids are slow-growing neoplasms that are characterized by a benign proliferation of fibroblasts in the setting of an altered cytokine profile. The traditional treatment modalities for external ear keloids are often associated with high recurrence rates.
OBJECTIVE
The purpose of this study is to investigate the efficacy and safety of applying imiquimod 5% cream after parallel shave excision for the treatment of external ear keloids.
METHODS
Twenty-two keloids from 19 patients were treated with parallel shave excision and this was followed by daily application of imiquimod 5% cream for 8 weeks. The patients were examined every 2 weeks for up to 24 weeks for recurrence of the keloids and any side effects.
RESULTS
At the end of the 24-week follow-up period, 15 keloids (68.2%) remained recurrence free. Seven of these have remained recurrence free for a period ranging from 29 to 131 weeks. The common local side effects were burning (59.1%), pain (36.4%) and itching (27.3%), but there were no severe systemic side effects. Most of the patients experienced erythema (90.9%) and crust (77.3%) at the application sites and 3 patients (13.6%) reported transient hyperpigmentation on the surrounding areas.
CONCLUSION
The application of imiquimod 5% cream after parallel shave excision can be an effective treatment modality for external ear keloids with mild and acceptable side effects.