{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:59:03Z","timestamp":1790413143816,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Keloids (KSs) and hypertrophic scars (HSs) occur more frequently in populations with higher and mixed skin phototypes, such as those in Latin America. While lasers and other energy\u2010based devices (EBDs) have broadened therapeutic options for scar management, their use in darker and genetically diverse populations presents specific challenges, especially concerning pigmentary complications and treatment safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to develop a consensus among Latin American experts on the safe and effective use of lasers, EBDs and combination therapies for managing KSs\/HSs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Delphi\u2010based consensus process was conducted among 22 Latin American dermatologists specialized in scar management. The experts evaluated 23 representative clinical scenarios over three anonymous iterative rounds. They selected first\u2010 and second\u2010line treatments from a predefined list of therapeutic options, which included lasers, injectables, dressings and adjunctive therapies. Consensus was defined in advance using established agreement thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus was reached for nearly all (21 of 23) clinical scenarios. Early and inflammatory scars were primarily treated with vascular\u2010targeting devices, silicone or hydrocolloid dressings and low\u2010level light therapy. Actively growing KSs\/HSs were primarily treated with intralesional corticosteroids combined with 5\u2010fluorouracil or bleomycin, often integrated with vascular lasers or occlusive dressings. Fractional lasers were recommended primarily to improve texture after scar flattening, whereas pigment\u2010targeting modalities were preferred to address residual dyschromia. Combination therapies were consistently preferred over monotherapies, and specific safety recommendations were established for individuals with higher skin phototypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This consensus provides population\u2010adapted guidance for the multimodal management of scars in Latin American patients and may improve outcomes while minimizing adverse effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.70636","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:03:41Z","timestamp":1786370621000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Consensus on energy\u2010based devices for keloids and hypertrophic scars: A Latin American Delphi study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5101-7097","authenticated-orcid":false,"given":"Gisele","family":"Viana de Oliveira","sequence":"first","affiliation":[{"name":"Post Graduation Department, Faculty of Medical Sciences of Minas Gerais, Brazil, Santa Casa de Belo Horizonte, Hospital Luxemburgo and GREMCIQ \u2013 Group of Multicenter Studies of Keloids and Scars  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia Apt","family":"Druck","sequence":"additional","affiliation":[{"name":"Universidad del Desarrollo  Santiago Chile"},{"name":"Clinica Alemana de Santiago  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro Andres Luque","family":"Acevedo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Centro Dermatologico Federico Lleras Acosta  Bogot\u00e1 Colombia"},{"name":"Private Practice  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0615-9026","authenticated-orcid":false,"given":"Doris","family":"Hexsel","sequence":"additional","affiliation":[{"name":"Hexsel Dermatologic Clinics  Porto Alegre Brazil"},{"name":"Brazilian Center for Studies in Dermatology  Porto Alegre Brazil"},{"name":"GREMCIQ \u2013 Group of Multicenter Studies of Keloids and Scars  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Teixeira","family":"Gontijo","sequence":"additional","affiliation":[{"name":"Dermatology Practice  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Huerta","family":"Rivera","sequence":"additional","affiliation":[{"name":"Department of Dermatology Universidad LAMAR  Guadalajara Mexico"},{"name":"Dermacenter Clinic  Guadalajara Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Leobardo","family":"Vel\u00e1zquez\u2010Arenas","sequence":"additional","affiliation":[{"name":"Instituto Tecnologico de Monterrey  Monterrey M\u00e9xico"},{"name":"Private Practice  Monterrey M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fl\u00e1via Alvim Sant Anna","family":"Addor","sequence":"additional","affiliation":[{"name":"GREMCIQ \u2013 Group of Multicenter Studies of Keloids and Scars  Belo Horizonte Brazil"},{"name":"Grupo MEDCIN (Centro de Pesquisa Cl\u00ednica)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1tima Ag\u00fcero","family":"Zaputovich","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias M\u00e9dicas Universidad Nacional de Asunci\u00f3n  Asunci\u00f3n Paraguay"},{"name":"DERMALASER  Asunci\u00f3n Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Leal\u2010Silva","sequence":"additional","affiliation":[{"name":"Department of 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