蟹足腫体質的人，身上一有傷痕，就會長出凸出而且肥厚的疤痕，令愛美人士深惡痛絕。在組織學上，可以看到未成熟的膠原蛋白過度增生，而且無法排列整齊成熟，也就是說傷口癒合的最後步驟無法正常完成。
由於醫界對蟹足腫的發生原因仍然不清楚，所以無法針對原因來做治療。而根據過去的經驗和一些揣測，現在臨床上用來處理或減輕蟹足腫的方法有：1.外科手術切除; 2. 注射類固醇; 3.用繃帶壓; 4. 貼矽膠片; 5. 放射線照射
但是上述這些方法無論是單獨或是綜合使用，都無法讓復發率達到70%以上。 另外有一些藥劑也有些人聲稱有效，如 5-FU(化療藥物), retinoids(A酸), Vit. A derivatives (維生素A衍生物), 及 interferon alpha-2b(干擾素) 等等。本文即在測試干擾素是否真的對蟹足腫的再發有抑制作用。
Author Davison, Steven P. M.D., D.D.S.; Mess, Sarah M.D.; Kauffman, Lisa C. M.D.; Al-Attar, Ali M.D., Ph.D.
Institution Washington, D.C.
From the Department of Plastic Surgery and the Division of Dermatology, Georgetown University Medical Center.Title Ineffective Treatment of Keloids with Interferon Alpha-2b.
Source Plastic & Reconstructive Surgery. 117(1):247-252, January 2006.
Abstract
Background: Keloids are exuberant, disfiguring scars that result from an abnormal healing process. Current established treatment strategies include surgical resection, triamcinolone steroid injection, pressure therapy, silicone therapy, and radiotherapy. None of these therapies, either alone or in combination, offers consistent recurrence-free rates above 70 to 80 percent. The antiproliferative, antifibrotic cytokine, interferon alpha-2b, may be useful in keloid management because of its ability to interfere with collagen synthesis and fibroblast proliferation.Methods: To determine the efficacy of interferon alpha-2b in keloid management, the authors prospectively evaluated the effects of interferon alpha-2b as postexcisional adjuvant therapy for keloids. Thirty-nine keloids in 34 patients were photographed, measured, and surgically excised. The wound bed was injected twice with either interferon alpha-2b (treatment group; n = 13 keloids) or triamcinolone (control group; n = 26 keloids) at surgery and 1 week later. The patients were followed up in the plastic surgery clinic.
Results: The trial protocol was terminated at midtrial surveillance. Among the 13 keloids that were treated with postoperative intralesional interferon alpha-2b, seven recurred (54 percent recurrence rate). In contrast, in the 26 keloids that received triamcinolone (control group), only four recurred (15 percent recurrence rate). Recurrence in either group did not correlate with location of the keloid or race.
Conclusion: Interferon does not appear to be effective in the clinical management of keloids.
這個實驗用了39處蟹足腫，先手術切除後，其中的13處注射干擾素alpha 2b; 另外26處注射類固醇(triamcinolone)。結果實驗做到一半就被迫中止了。因為注射干擾素的13處中, 有7處復發；而注射類固醇的26處，只有4處復發。 因此，這個實驗簡單的說就是注射干擾素對抑制蟹足腫的復發沒有幫助。
順便一提，門診時常有人問我擦一些什麼 080 之類的去疤膏有沒有用？比較中庸和謹慎的回答是：看一看這些藥膏的成份，是不是含有我上面列的那些藥物？若是有，那可能會有效；若是沒有？至少醫學界尚無法證實有效。
