Bleomycin is widely used as an off-label treatment for various dermatologic indications. However, a much-needed critical appraisal of the currently available evidence is lacking. We therefore evaluated the quality of clinical evidence for the efficacy and safety of intralesional bleomycin treatment for dermatologic indications with the aim to provide evidence-based recommendations for clinical practice. The PubMed, Embase, Medline Ovid, Web of Science, Cochrane Central, and Google Scholar databases were systematically searched. Two authors independently selected relevant studies according to predefined inclusion and exclusion criteria. We assessed the methodologic quality with the Cochrane Collaboration risk-of-bias assessment tool and selected 10 randomized clinical trials and 15 clinical controlled trials. Treatment indications included common warts, nonmelanoma skin cancer, cutaneous metastases, keloid and hypertrophic scars, and hemangioma. Intralesional bleomycin treatment showed significantly higher cure rates for warts compared with other treatments. Local adverse events included erythema, blackening, eschar formation, and superficial ulceration. None of the studies reported systemic adverse events. Methodologic quality of the studies was generally low. Consequently, no firm recommendations can be made for intralesional bleomycin treatment in clinical practice. However, this review suggests that intralesional bleomycin is a successful and well-tolerated treatment for recalcitrant warts.

博来霉素被广泛用作各种皮肤病适应症的标签外治疗。然而，目前缺乏对现有证据的急需的批判性评估。因此，我们评估了病灶内注射博来霉素治疗皮肤病适应症的有效性和安全性的临床证据质量，目的是为临床实践提供循证建议。系统地搜索了 PubMed、Embase、Medline Ovid、Web of Science、Cochrane Central 和 Google Scholar 数据库。两位作者根据预定义的纳入和排除标准独立选择相关研究。我们使用 Cochrane Collaboration 偏倚风险评估工具评估了方法学质量，并选择了 10 项随机临床试验和 15 项临床对照试验。治疗适应症包括普通疣、非黑色素瘤皮肤癌、皮肤转移瘤、瘢痕疙瘩和肥厚性瘢痕以及血管瘤。与其他治疗相比，病灶内注射博来霉素治疗疣的治愈率显着更高。局部不良事件包括红斑、变黑、焦痂形成和表面溃疡。没有一项研究报告全身性不良事件。研究的方法学质量普遍较低。因此，在临床实践中不能对病灶内注射博来霉素提出明确的建议。然而，该评价表明病灶内注射博来霉素是治疗顽固性疣的一种成功且耐受性良好的治疗方法。与其他治疗相比，病灶内注射博来霉素治疗疣的治愈率显着更高。局部不良事件包括红斑、变黑、焦痂形成和表面溃疡。没有一项研究报告全身性不良事件。研究的方法学质量普遍较低。因此，在临床实践中不能对病灶内注射博来霉素提出明确的建议。然而，该评价表明病灶内注射博来霉素是治疗顽固性疣的一种成功且耐受性良好的治疗方法。与其他治疗相比，病灶内注射博来霉素治疗疣的治愈率显着更高。局部不良事件包括红斑、变黑、焦痂形成和表面溃疡。没有一项研究报告全身性不良事件。研究的方法学质量普遍较低。因此，在临床实践中不能对病灶内注射博来霉素提出明确的建议。然而，该评价表明病灶内注射博来霉素是治疗顽固性疣的一种成功且耐受性良好的治疗方法。在临床实践中，没有对病灶内注射博来霉素的确切建议。然而，该评价表明病灶内注射博来霉素是治疗顽固性疣的一种成功且耐受性良好的治疗方法。在临床实践中，没有对病灶内注射博来霉素的确切建议。然而，该评价表明病灶内注射博来霉素是治疗顽固性疣的一种成功且耐受性良好的治疗方法。