The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

Abstract

Background: Management of keloid is difficult as well as challenging. Intralesional triamcinolone acetonide (TAC) injections have remained a gold standard in non-surgical management of keloid. TAC is generally used in the concentration of 40mg/ml, which causes adverse effects such as local dermal atrophy and hypopigmentation. Aim was to study efficacy and adverse effects of TAC in treatment of keloid, in a lesser concentration of 20mg/ml.Methods: An open label study was conducted from November 2015 to May 2017 on 25 subjects of either gender, in the age group 11-55 years, at a medical college hospital. Intralesional injection TAC 20 was administered in the keloid at an interval of 3 weeks, for a total of 6 sessions, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement and SPSS 21 for statistical analysis.Results: Mean age of keloid subjects was 30.72 years and median duration of keloid was 8 months. The mean VSS score before treatment was 8.36 which reduced to 3.20 after treatment. Mean percentage change in VSS score was 62.79%, which was very highly significant (p <0.001). Physician’s assessment was ‘Very Good’ in 52.0% and ‘Excellent’ in 5 (20%). Adverse effect of atrophy was seen in 3 (12%), hypopigmentation in 11 (44%) and telangiectasia in 4 (16%).Conclusions: Intralesional injection triamcinolone acetonide 20mg/ml gives very good to excellent improvement in the majority of patients of keloid. Local adverse effects seen were hypopigmentation, atrophy and telengiectasia.