Table 2.
Characteristics of Studies Included in the Systematic Review
| Author, y | Country, Institution, Study Period |
Methods | Inclusion and Exclusion Criteria | Number of Patients | Mean Age (y) | Male% | Reported Outcomes |
|---|---|---|---|---|---|---|---|
| Hu et al., 2020 | China, Zhejiang University School of Medicine, June 2015–June 2018 |
134 patients with thyroidectomy scars divided into four groups: ACE-I–treated group, ARB-treated group, other antihypertensive drugs control–treated group, and blank control–treated group | Post-thyroidectomy scars, without hypertension or with well-controlled hypertension (<140/90 mm Hg). | All (134) ACE-I (22) ARB (24) Other antihypertensive drugs (34) Blank control (54) |
55 51 58 58 53 |
19% 36% 17% 9% 19% |
Width, length, SCAR score |
| Hedayatyanfard et al., 2018 | Iran, Shahid Beheshti University and Modarres Hospital, 2015–2016 |
Subjects 37 patients each with keloid or hypertrophic scarring >2 cm in length. Intervention Patients were randomized to receive either topical 5% losartan cream or placebo twice daily for 3 months. |
Scars >2 cm in length for <6 months. Not taking antihypertensive drugs, not pregnant, no malignancy, no allergy history, no bleeding and discharge in scar tissue, and no scar treatment in the past 2 months. | All (30) Losartan (20) Placebo (17 with 10 included in the analysis) |
31.7 47.6 | 50% 30% |
Vancouver Scar Scale |
| Mohammadi et al., 2018 | Iran, Shiraz Burn and Wound Healing Research Center |
Subjects 30 patients each with two same-degree hypertrophic scars on symmetrical body sites. Intervention Scar sites in each subject were randomized to receive 1% enalapril ointment or placebo twice daily for 6 months. |
Hypertrophic scars and itching after second- or third-degree burns with same-degree scars on symmetrical anatomic body sites. | 30 1% enalapril ointment and Placebo |
NA | 50% | Scar size |
| Alexandrescu et al., 2016 | US, University of San Diego |
Male aged 30 years with five chest keloids: one received intralesional 5-FU/TMC, one received intralesional 5-FU/verapamil, one received intralesional enalapril alone, one received intralesional verapamil alone, and the last one underwent fractional carbon dioxide laser. Each injection was done at 1-week intervals for a total of 17 treatments. | Male aged 30 years with five chest keloids. | 1 | 30 | 100% | Diameter change, softening, height, pain, itching. |
| Ardekani et al., 2009 | Iran, Shiraz University of Medical Sciences |
Case report of a female aged 18 years with a burn injury–induced keloid treated with topical 5% captopril cream twice daily for 4 months. | Female aged 18 years with a left dorsal hand burn injury–induced keloid treated with topical 5% captopril cream twice daily. | 1 | 18 | 0% | Keloid height and redness |
| Iannello et al., 2006 | Italy, University of Catania |
Case study of two patients with keloid scarring after abdominal surgery who were subsequently started on oral antihypertensive therapy containing enalapril for 3–4 months and 6 months of treatment, respectively. | Two patients with postsurgical keloidal scarring who were initiated on oral antihypertensive therapy containing the ACE-I enalapril | 2 | 62 | 0% | Keloid improvement |
| Ogawa et al., 2013 | Japan, Nippon Medical School |
Case report of a female aged 63 years with right arm keloids who received treatment with surgical excision and postoperative radiation therapy, which was supplemented with amlodipine and candesartan systemically for 2 years. | Woman aged 63 years with hypertension and right arm keloids, treated with surgery, radiation therapy, amlodipine, and candesartan cilexetil. | 1 | 63 | 0% | Symptom improvement |
Abbreviations: 5-FU, fluorouracil; ACE-I, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; NA, not applicable; SCAR, Scar Cosmesis Assessment and Rating; TMC, triamcinolone; US, United States.