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KeloidNCT07836569

Outcomes of the A.S.A.P. Algorithm for Keloids: A Controlled Prospective Study

A study testing A.S.A.P. Algorithm in people with Keloid, run by Gisele Viana de Oliveira at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this clinical trial is to evaluate if the A.S.A.P. algorithm can treat and improve clinical and objective outcomes in patients with keloids. The main questions it aims to answer are: Does sequential treatment with the A.S.A.P. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Keloid
What is being tested?
A.S.A.P. Algorithm
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
116 participants
Where
1 siteBrazil
Study dates
1 Sep 2025to 10 Sep 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female patients aged 18 years or older
  • Clinical diagnosis of keloid established by an experienced senior dermatologist
  • No treatment received for keloid for at least 12 months prior to study enrollment
  • Willingness to participate in the study, documented by written informed consent

Who cannot join

  • Concomitant medical conditions requiring systemic corticosteroids or immunosuppressive therapy
  • Failure to adhere to the proposed treatment protocol

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Gisele Viana Dermatologia

    Belo Horizonte, Minas Gerais, 30320-670

Other trials in Brazil

About this study

Official title: Clinical and Objective Outcomes of the A.S.A.P. Algorithm for Keloids: A Prospective Longitudinal Within-Patient Study With an Untreated Comparison Group

The goal of this clinical trial is to evaluate if the A.S.A.P. algorithm can treat and improve clinical and objective outcomes in patients with keloids.

The main questions it aims to answer are:

Read more

Does sequential treatment with the A.S.A.P. algorithm significantly improve keloid scar characteristics and firmness compared to baseline? Are the longitudinal clinical and objective improvements greater in keloids treated with the A.S.A.P. algorithm compared to an untreated control group? Researchers will compare keloids treated with the sequential A.S.A.P. algorithm to a concurrent untreated group of keloids to see if the treatment algorithm produces superior improvements in scar severity and firmness.

Participants will:

Undergo sequential treatment according to the A.S.A.P. algorithm for at least 6 months, which includes hydrocolloid occlusion, Low-Level Laser Therapy (LLLT), vascular-targeted technologies, intralesional triamcinolone plus 5-fluorouracil, and treatment of residual pigmentation.

Complete clinical scar evaluations at baseline and follow-up using the Vancouver Scar Scale (VSS) and Hamilton Scar Scale.

Undergo objective scar firmness measurements at baseline and follow-up using a durometer.

If in the nonrandomized control group, be prospectively observed and assessed at baseline and follow-up without receiving active treatment.

Read the detailed description

Keloid management remains challenging due to clinical heterogeneity, variable treatment responses, and limited objective evidence supporting multimodal treatment strategies. The A.S.A.P. algorithm is a structured, sequential, predominantly nonsurgical protocol incorporating Assessment, Softening, Approach, and Pigmentation management.

This prospective, longitudinal, quasi-experimental study aims to evaluate within-patient changes in clinical and objective keloid outcomes following treatment with the A.S.A.P. algorithm over a minimum 6-month period, while comparing these changes against a concurrent nonrandomized group of untreated keloids.

Study Workflow:

Assessment (A): Initial clinical evaluation, symptom assessment, and classification of keloid lesions.

Softening (S): Application of hydrocolloid occlusion, silicone dressings, or pressure garments for 2-12 months to reduce tissue firmness, alleviate symptoms, and prepare the lesion for injections.

Approach (A): Utilization of vascular-targeted technologies (such as Intense Pulsed Light - IPL) followed by monthly intralesional injections combining triamcinolone hexacetonide (TH) with 5-fluorouracil (5-FU) or bleomycin.

Pigmentation \& Quality (P): Management of residual hyperpigmentation or hypopigmentation and skin texture using topical therapies (hydroquinone, glycolic acid, 8-methoxypsoralen [8-MOP]), chemical peels, microneedling, or fractional lasers.

Outcome Measurements:

Lesion changes are evaluated at baseline and at follow-up intervals using the Vancouver Scar Scale (VSS), Hamilton Scar Scale, and objective durometer measurements to quantify skin firmness and elasticity.

Conditions
Keloid
Being tested
A.S.A.P. Algorithm
Keywords
Keloid, Multimodal Treatment, Cicatrix, Lasers
Medical subject headings
Keloid, Cicatrix

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • A.S.A.P. AlgorithmOther

    A - Assessment: Baseline clinical evaluation including standardized photo documentation, phototype assessment, and skin durometer measurements.

    S - Soften: Continuous occlusive hydrocolloid dressings (DuoDERM) secured with Micropore, changed biweekly in-clinic or self-managed with monthly evaluations.

    A - Approach: Monthly sessions of low-level laser therapy (7 minutes) and vascular technologies [Intense Pulsed Light (IPL) 540nm (12-17 J, 15 ms) and Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) 1064nm (3 mm spot, 20 J/cm², 620-650 ms)]. Followed immediately by intralesional injection of triamcinolone plus 5-fluorouracil (1:9 ratio; 0.2 mL per 1.5 cm², max 1.5 mL/session) and re-application of occlusive dressings.

    P - Pigmentation: After lesion flattening, pigmentary alterations are treated using light and laser devices (IPL 640nm, picosecond laser), retinoic acid peels, and topical depigmenting agents.

Study groups in NCT07836569
Study groupRoleWhat they receive
A.S.A.P. Treatment GroupExperimentalPatients receiving sequential treatment according to the A.S.A.P. algorithm.
Receives: Other: A.S.A.P. Algorithm
Untreated Control GroupNo interventionConcurrent nonrandomized control group prospectively observed and assessed at baseline and follow-up without active treatment.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline in Vancouver Scar Scale (VSS) Score

    The VSS evaluates four clinical scar parameters: vascularity (0-3), pigmentation (0-2), pliability (0-5), and height (0-3), yielding a total score ranging from 0 to 13. Lower scores represent clinical improvement, while higher scores indicate greater scar severity.

    Measured: Baseline and at least 6 months post-treatment initiation

Secondary outcomes (4)
  1. Change from Baseline in Hamilton Scar Scale Score

    Clinical assessment of scar characteristics using the Hamilton Burn-Scar Rating Scale, evaluating thickness (0-3), irregularity (0-4), vascularity (0-4), and pigmentation (0-3). Total score ranges from 0 to 14, where 0 represents normal skin and 14 represents maximum scar severity. Higher scores indicate worse outcome.

    Measured: Baseline and at least 6 months post-treatment initiation

  2. Change from Baseline in Objective Scar Firmness

    Objective measurement of keloid tissue induration and hardness performed using a skin durometer.

    Measured: Baseline and at least 6 months post-treatment initiation

  3. QualiFibro: Quality of Life Questionnaire for Patients with Fibroproliferative Scars

    Minimum score: -5 Maximum score: +5 Direction: Higher scores indicate a worse outcome (greater impact of the scar on physical and psychological well-being).

    Measured: Baseline and 6-18 months post-treatment initiation

  4. Beck Depression Inventory-II

    Minimum score: 0

    Maximum score: 63

    Scale: 21 items, each scored from 0 to 3.

    These values refer to the BDI-II (Beck Depression Inventory-II).

    Measured: Baseline and at least 6 months post-treatment initiation.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Sep 2026
  2. Study start1 Sep 2025
  3. Primary completion1 Jul 2026
  4. Study completion10 Sep 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
Participants are allocated into two concurrent groups: a treatment group and a nonrandomized control group. Patients in the treatment group undergo sequential A.S.A.P. protocol management for at least 6 months, with each treated keloid evaluated against its own baseline. Active treatment comprises hydrocolloid occlusion, low-level laser therapy, vascular-targeted technologies, and intralesional triamcinolone plus 5-fluorouracil, followed by management of residual pigmentation when indicated. Concurrently, a nonrandomized control group of untreated keloids is prospectively followed as a comparator. Outcomes in both groups are assessed at baseline and follow-up using the Vancouver Scar Scale (VSS), Hamilton Scar Scale, and objective durometer measurements. Within-patient changes are quantified, and longitudinal changes from baseline are subsequently compared between the treated and untreated groups. Also, secondary outcomes include evaluation of quality of life psychosocial indicators.
Masking
None (open label)
Enrolment
116 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07836569
Sponsor's protocol ID
65135922.0.3001.5134
Status last verified
Sep 2026
First submitted
17 Sep 2026
Last updated
29 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The datasets generated and analyzed during the current study are not publicly available due to patient privacy restrictions, but are available from the corresponding author upon reasonable request.

Publications

  • Conte S, Kamali K, Muncey-Buckley M, Abbas K, Sabljic T, Mukovozov IM. Complications of Body Piercings: A Systematic Review. Cutis. 2023 Sep;112(3):139-145. doi: 10.12788/cutis.0847.

    PubMed 37903388
  • Murray JC, Pollack SV, Pinnell SR. Keloids: a review. J Am Acad Dermatol. 1981 Apr;4(4):461-70. doi: 10.1016/s0190-9622(81)70048-3.

    PubMed 7014664
  • Ogawa R. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. Int J Mol Sci. 2017 Mar 10;18(3):606. doi: 10.3390/ijms18030606.

    PubMed 28287424
  • Kim HJ, Kim YH. Comprehensive Insights into Keloid Pathogenesis and Advanced Therapeutic Strategies. Int J Mol Sci. 2024 Aug 12;25(16):8776. doi: 10.3390/ijms25168776.

    PubMed 39201463
  • Valle LNDC, Mendes VB, Melchiors Stahlschmidt AP, Andrade FR, Silva MR, de Oliveira GV. Body appreciation and psychosocial indicators in patients with keloids, hypertrophic scars, and burn scars. Scars Burn Heal. 2026 Jul 24;12:20595131261468100. doi: 10.1177/20595131261468100. eCollection 2026 Jan-Dec.

    PubMed 42502838
  • Falanga V, Bucalo B. Use of a durometer to assess skin hardness. J Am Acad Dermatol. 1993 Jul;29(1):47-51. doi: 10.1016/0190-9622(93)70150-r.

    PubMed 8315077
  • Shaheen A, Khaddam J, Kesh F. Risk factors of keloids in Syrians. BMC Dermatol. 2016 Sep 20;16(1):13. doi: 10.1186/s12895-016-0050-5.

    PubMed 27646558
  • Brandao MPAS, Vieira CFO, Rocha DBB, Silva MR, da Silva JA, Gold MH, de Oliveira GV. Outcomes of a Non-Surgical Combination Therapy for Keloids in Skin of Color Patients: A 10-Year Follow-Up Study. Int J Dermatol. 2025 Aug;64(8):1434-1440. doi: 10.1111/ijd.17829. Epub 2025 May 5.

    PubMed 40322860
  • de Oliveira GV, Nunes TA, Magna LA, Cintra ML, Kitten GT, Zarpellon S, Raposo Do Amaral CM. Silicone versus nonsilicone gel dressings: a controlled trial. Dermatol Surg. 2001 Aug;27(8):721-6. doi: 10.1046/j.1524-4725.2001.00345.x.

    PubMed 11493295
  • Oliveira GV, Chinkes D, Mitchell C, Oliveras G, Hawkins HK, Herndon DN. Objective assessment of burn scar vascularity, erythema, pliability, thickness, and planimetry. Dermatol Surg. 2005 Jan;31(1):48-58. doi: 10.1111/j.1524-4725.2005.31004.

    PubMed 15720096
  • Crowe JM, Simpson K, Johnson W, Allen J. Reliability of photographic analysis in determining change in scar appearance. J Burn Care Rehabil. 1998 Mar-Apr;19(2):183-6. doi: 10.1097/00004630-199803000-00019.

    PubMed 9556325
  • Sullivan T, Smith J, Kermode J, McIver E, Courtemanche DJ. Rating the burn scar. J Burn Care Rehabil. 1990 May-Jun;11(3):256-60. doi: 10.1097/00004630-199005000-00014.

    PubMed 2373734
  • van Zuijlen PP, Angeles AP, Kreis RW, Bos KE, Middelkoop E. Scar assessment tools: implications for current research. Plast Reconstr Surg. 2002 Mar;109(3):1108-22. doi: 10.1097/00006534-200203000-00052.

    PubMed 11884845
  • de Oliveira GV, Metsavaht LD, Kroumpouzos G. ASAP revisited: The Brazilian sequential algorithm for treating keloids and hypertrophic scars. Clin Dermatol. 2026 Jan-Feb;44(1):192-196. doi: 10.1016/j.clindermatol.2025.10.011. Epub 2025 Oct 29.

    PubMed 41173162
  • Viana de Oliveira G, Druck PA, Acevedo AAL, Hexsel D, Gontijo GT, Rivera GH, Velazquez-Arenas LL, Addor FASA, Zaputovich FA, Leal-Silva H, Leal-Delgado S, Escribens CE, Murillo KDO, Misticone S, D'orsi Metsavaht L, de la Riva J, Galimberti DR, Jedwab SKK, Garcia HRG, Silva MRE, Andrade MR, Reis-Filho E, Silva MR, Krompouzos G, Guzman-Sanchez D. Consensus on energy-based devices for keloids and hypertrophic scars: A Latin American Delphi study. J Eur Acad Dermatol Venereol. 2026 Aug 10. doi: 10.1111/jdv.70636. Online ahead of print.

    PubMed 42573498

Questions about this trial

What is this clinical trial studying?

A study testing A.S.A.P. Algorithm in people with Keloid, run by Gisele Viana de Oliveira at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline in Vancouver Scar Scale (VSS) Score (time frame: Baseline and at least 6 months post-treatment initiation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07836569, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Sep 2026.

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