Conclusion
On the basis of the fortuitous observation of a beneficial effect of enalapril on recent and long-standing postsurgical keloid scars and confirmatory data from the literature, ACE inhibitors and angiotensin-receptor antagonists (largely used in clinical practice) should be regarded as potentially useful therapeutic agents for patients with fibrotic diseases (such as lung fibrosis and postinfarction left ventricular remodeling) and, perhaps, also for healing bad cutaneous scars and repairing tissue.
Obviously, our observation is only a preliminary one, and our results should be compared to those observed with similar keloids not treated with enalapril.
During the posttraumatic or postoperative stage, it is difficult to achieve the best possible aesthetic when treating cutaneous scars. The proliferative phase occurs during the first few months, and pharmaceutical intervention can help to decrease the risk of aesthetically disfiguring hypertrophic or keloid scars, thereby avoiding revision surgery. Furthermore, surgically removed keloids commonly recur within the excision sites. Therefore, the precocious treatment with low-dose enalapril, which is not associated with side effects (except in patients with acute renal failure or chronic renal insufficiency and those with collagen vascular disease), is a possible solution; however, further confirmatory observations are needed.
© 2006 Medscape
Cite this: Low-Dose Enalapril in the Treatment of Surgical Cutaneous Hypertrophic Scar and Keloid - Two Case Reports and Literature Review - Medscape - Dec 20, 2006.
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