الفهرس 
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Abstract
Pathological scars are benign hyper-proliferative growths of dermal
collagen that causes severe psychological and physical problems. This study
was performed to assess and compare safety and efficiency of combined
long pulsed Nd-YAG laser and intralesional bleomycin versus long pulsed
Nd-YAG laser alone to treat the hypertrophic scars and keloids.
Patients and methods
Randomly, 40 patients with hypertrophic scars or keloids were
divided into two groups A and B. group A were handled by long pulsed
Nd:YAG laser and intralesional bleomycin while group B were handled by
long pulsed Nd:YAG laser only. Response was assessed subjectively by
clinical imaging and modified Vancouver Scar Scale (mVSS). While for
objective evaluation, skin biopsies were taken from volunteer patients
before and after treatment, and were examined by Hematoxylin and Eosin
staining and Masson trichrome staining.
Results
Our study demonstrated almost complete improvement in 4 (20%)
patients, partial improvement in 16 (80%) patients and 0 patients with no
improvement in group A. Furthermore, in group B, we demonstrated almost
complete improvement in 2 (10%) patients, partial in 14 (70%) patients and
no improvement in 4 (20%) patients. Modified Vancouver Scar Scale
reduced from 10.15 to 3.5 in group A and from 11.05 to 4.95 in group B.
Masson trichrome staining and Hematoxylin and eosin staining showed that
treatment in both groups structurally changed tissue collagen.
Conclusion
Long-pulsed Nd-YAG laser combined with intralesional bleomycin
could be a promising way for treatment of keloids or hypertrophic scars.