6. Needle-free electronically-controlled jet injector treatment with bleomycin and lidocaine is effective and welltolerated in patients with recalcitrant keloids. 149 6. demonstrated that Intralesional bleomycin delivered with conventional needles is associated with a significantly lower risk of recurrence compared to intralesional corticosteroids in the treatment of keloids.19 Lidocaine is usually added to intralesional bleomycin to reduce pain at the injection site and to increase the intracellular uptake of bleomycin.20 EPI-assisted intralesional administration of bleomycin with lidocaine, could be a suitable alternative treatment for patients with recalcitrant keloids that have previously failed or discontinued intralesional corticosteroid therapy or experienced a fast recurrence. Therefore, in this retrospective cohort study, we aimed to investigate the effectiveness, safety and patient satisfaction of EPI-assisted intralesional bleomycin with lidocaine in patients with recalcitrant keloids.
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