Treatment of auricular keloids by triple combination therapy: Surgical excision, platelet-rich plasma, and cryosurgery.

Abstract

Surgical excision alone for auricular keloids is frequently followed by recurrence making combining treatment options necessary. We aimed to assess the long-term efficacy of combining surgical excision, cryosurgery, and platelet-rich plasma (PRP) in treatment of auricular keloids. This interventional study was carried out on fifty auricular keloids in 50 patients. Patients were subjected to a combination therapy of surgical excision of the keloids, intraoperative cryosurgery, and PRP injections. The primary endpoint was defined as the number of patients who achieved major flattening of the keloid (reduction of more than 80% of the keloid) after a follow-up of 12 months. After follow-up of 12 months, 74% of the keloids achieved complete flattening in 10 cases and significant flattening in 14 cases. Thirty-four of the 50 keloids (68%) were treated with only excision, cryosurgery, and PRP and did not relapse. Three keloids (6%) had minor relapse after the first treatment but were considered persistent major flattening at the end of the study. Three other keloids (6%) needed intralesional triamcinolone to achieve major or complete flattening without further relapse. Treatment failure was observed in 30% who achieved <30% reduction in their surface. Treatment side effects were transient pain and focal hypoesthesia. This combination therapy was effective for treatment of auricular keloids, with a low recurrence rate and a favorable cosmetic outcome. Therapy was well tolerated and without significant side effects.