Intralesional verapamil in the treatment of keloids: A clinical, histopathological, and immunohistochemical study

Abstract Introduction The histopathological changes and immunohistochemical studies occurring in keloids in vivo after treatment by intralesional (IL) verapamil are not yet assessed. This study aimed to evaluate the efficacy and safety as well as the histological/immunohistochemical effects of intralesional verapamil on keloids. Patients and methods Thirty‐one patients with 43 keloids were treated with IL verapamil at 3‐week intervals until reaching complete flattening of the lesion or for a maximum of 6 sessions. Keloid biopsies were obtained before and after treatment for evaluation of histopathological changes and the immunohistochemical expression of VEGF and MMP9. Results Of 43 keloids, 6 keloids (14%) and 17 (39.5%) showed excellent and good improvement, respectively, with no significant side effects except for pain at the site of injection. Histopathological and immunohistochemical evaluations were consistent with the clinical observations after treatment, and there was a statistically significant decrease in VEGF and MMP9 expressions after treatment. Conclusion IL verapamil is effective in the treatment of keloids which is possibly attributed to suppression of MMP9 and VEGF. It is a simple and relatively safe treatment method for keloids.