Abstract
Background: A wide range of therapies exist for keloids. But despite the multiple treatment modalities available, keloids still remain a significant challenge for both the clinician and the patient. Objective: To assess the effectiveness and safety of debulking of keloid with intralesional injection of 5-flurouracil and triamcinolone in comparison to intralesional injection of 5-flurouracil and triamcinolone alone. Patient and Methods: This single blinded comparative therapeutic outpatient based study was done at the Department of Dermatology, Baghdad Teaching Hospital during the period from February 2011 to February 2013. Twenty-three patients with 52 lesions were enrolled in the study and consisted of two groups: Group A (26 lesions): Treated by intralesional injection of combination of 5-flurouracil and triamcinolone acetonide and repeated every month; Group B (26 lesions): Debulking was carried out first and then injection of combination of 5-flurouracil and triamcinolone acetonide at time of operation and then repeated injection monthly. Evaluation was performed by scoring system with 5 criteria (redness, elevation, hardness, itching and tenderness). The response was graded as no response, minimal, moderate or complete response. Results: Both modalities of treatments showed significant results in treating keloid, but the intralesional therapy alone was slightly better than debulking plus intralesional and no systemic adverse effects were noticed in both groups. Conclusion: Both modalities of therapy were effective in treatment of keloid, and there was no much difference between them.
Highlights
Keloid is a benign proliferative lesion of the dermal connective tissue that usually results from an excessive tissue response to cutaneous trauma in genetically predisposed individuals, which usually does not resolve spontaneously [1] [2]
Keloid occurs in all races with a predominance of the disease in African in which it occurs more in pigmented tribes
This study consists of two groups: Group A: (n = 26 lesions) patients were given1ml of 5-FU (50 mg with up to a maximum of 2 ml being used per dose) and 0.5 ml triamcinolone acetonide (20 mg) and 1ml 2% xylocain as combination to infiltrate the keloid without removal
Summary
Keloid is a benign proliferative lesion of the dermal connective tissue that usually results from an excessive tissue response to cutaneous trauma in genetically predisposed individuals, which usually does not resolve spontaneously [1] [2]. There is no routinely effective therapy for all keloids, but a variety of treatment methods exist [5]-[7]. The variety of treatment methods suggests that none is very satisfactory as the lesion is notoriously recurrent. These include surgical excision, intralesional steroid injection, cryotherapy, laser therapy, use of ionizing radiation, mechanical compression dressing, silicone sheet applications, ultrasound and heat therapy, intralesional interferon injection, or combination of techniques, and many others (Table 1) [8]-[12]. Results: Both modalities of treatments showed significant results in treating keloid, but the intralesional therapy alone was slightly better than debulking plus intralesional and no systemic adverse effects were noticed in both groups. Conclusion: Both modalities of therapy were effective in treatment of keloid, and there was no much difference between them
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