Intralesional Steroid Injection Research Articles

Intralesional steroid injections for inflammatory nail dystrophies in the pediatric population.

Intralesional injections of triamcinolone acetonide are widely used to successfully treat several inflammatory nail conditions. This procedure is well described in adults, but less frequently reported in children and teenagers, being largely considered too invasive and fear-provoking for pediatric patients. Our report shows how this procedure is feasible and successful in children, even without a digital block. The step-by-step technique and tips to reduce pain should encourage clinicians to offer it as an alternative option to children with inflammatory nail disorders.

A rare case of inclusion body fibromatosis

Infantile digital fibromatosis is a marked fibrous proliferation of infancy characterized by occurrence in the fingers and toes and a marked tendency for local recurrence. It accounts for 0.2% of registered soft tissue tumors. The lesion rarely exceeds 2 cm and tends to regress spontaneously. The presence of characteristic inclusion bodies in the cytoplasm of neoplastic fibroblasts distinguishes it from other fibromatosis. Current treatment recommendations include function-preserving excision and intralesional steroid injections for symptomatic lesions. Although lesions recur more than 60% of the time after excision, the ultimate prognosis is excellent.

Treatment of Vocal Fold Nodules: Transnasal Steroid Injection Versus Microlaryngoscopic Phonomicrosurgery

Vocal fold nodules (VFNs) are bilateral, mid-membranous, swellings of the vocal folds. Intralesional steroid injection was successfully tried in the management of benign vocal fold lesions including nodules. The aim of the present study was to compare treatment outcomes of vocal fold steroid injection (VFSI) and surgery in patients with VFNs in terms of lesion regression, subjective, and objective voice parameters. Nonrandomized controlled clinical trial. This bicenter interventional study was conducted on 32 patients with VFNs, in the age range of 16-63 years. Sixteen patients underwent transnasal VFSI under local anesthesia (the injection group), and 16 underwent surgical excision of the nodules under general anesthesia (the surgery group). Prior to intervention and at the follow-up visit, participants were subjected to videolaryngoscopic examination with evaluation of nodules' sizes as well as subjective voice assessment by auditory perceptual assessment (APA) of voice and the international nine-item Voice Handicap Index (VHI-9i). Objective voice assessments including the measurements of cepstral peak prominence, jitter, shimmer, harmonic to noise ratio, and maximum phonation time were also administered. The size of vocal fold nodules was significantly decreased postintervention in both studied groups. There was a decrease in the VHI-9i score, a decrease in the values of jitter and shimmer, together with an increase in the values of cepstral peak prominence and maximum phonation time after interventions indicating improvement of subjective and objective voice outcomes in both groups. Office-based transnasal VFSI is a safe and tolerable therapy option for VFNs. Voice outcomes of VFSI were comparable to surgery, hereby VFSI can be considered a promising therapy for VFNs and could be used as an alternative to surgery in selected cases.

Mucocele of the lower lip: A case report of a benign salivary gland cyst

We report a case of Mucocele in a 35-year-old male patient. Mucoceles are one of the most frequent lesion of the oral mucosa. The most common affected site is the lower lip. The most common treatment for mucocele is excision, however recurrence is common. Other treatment modalities available are Cryosurgery, CO 2 laser ablation, Intralesional steroid injection, and Diode lasers.

Long-Term Follow-up of 64 Patients With Idiopathic Subglottic Stenosis: Treatment Pathways, Outcomes, and Impact of Serial Intralesional Steroid Injections.

To describe treatment pathways and long-term outcomes in 64 patients with idiopathic subglottic stenosis (iSGS), including the impact of serial intralesional steroid injection (SILSI) on degree of stenosis, need for subsequent operation, and patient-reported outcome measures. Retrospective review of 64 female patients with iSGS undergoing varied management approaches, 57 of whom underwent SILSI as at least part of their care. Treatment pathways included SILSI only, endoscopic intervention followed by SILSI only, endoscopic interventions only, endoscopic intervention followed by SILSI followed by need for repeat endoscopic intervention, open surgery, and tracheotomy. Outcomes assessed included subjectively estimated percent airway stenosis, dyspnea index (DI), modified medical research council (MMRC) dyspnea scale, voice handicap index-10 (VHI-10), number of operative and office-based procedures performed, need for subsequent operative intervention, and inter-operative interval. Treatment pathways included SILSI alone (n = 6), endoscopic intervention(s) followed by SILSI only (n = 31), SILSI followed by additional endoscopic or office-based procedures (n = 16), open surgery (n = 3), and tracheostomy (n = 4). 57 of 64 patients underwent SILSI as at least part of their treatment. Inter-operative interval was increased after starting SILSI. Of patients undergoing SILSI, those with more procedures or shorter inter-operative interval prior to SILSI were more likely to return to the operating room. Estimated stenosis, DI, MMRC, and VHI-10 decreased with SILSI. Stenosis was not correlated with DI, MMRC, or VHI-10, though DI was correlated with both MMRC and VHI-10 score. Of 57 patients undergoing SILSI, 37 did not require further operative intervention. Improvements in inter-operative interval, dyspnea, and voice were observed across patients. Randomized trials to identify which patients may benefit most from SILSI are warranted.

Keloid with intra-lesional steroid injection

Introduction: Keloids are the result of an overgrowth of dense fibrous tissue that usually develops after healing of a skin injury. The exact pathogenesis of Keloids is unknown and their occurrence is spontaneous. The uncontrolled overgrowth of dense fibrous tissue extends beyond the borders of original wound and does not regress. No single therapeutic modality has been proven to be most effective for treatment therefore this study is plan to use intralesional steroids injection in keloid and measure the efficacy and to see if it is a better and cost effective method and also to determine its utility for clinical practice in dermatology in future. Objective: To determine the efficacy of intralesional steroid injections in keloids with dental syringe. Settings: Dermatology department, Jinnah Medical College Hospital in outpatient department (OPD). Duration: 06 months from 14th April’2018 to 14th Oct’ 2018. Design: Cohort Study. Subject and Methods: A total of 79 patients with having keloid were included in this study. During each visit, the size of the keloid was recorded centimeter using the Vernier's calipers, in terms of length, breadth, and height Injection triamcinolone acetonide was used in strength of 40 mg/ml.

Intralesional injection of platelet-rich plasma versus steroid in the treatment of oral lichen planus.

Oral licen planus (OLP) is a chronic inflammatory disease and may have immunological background. Both intralesional injection of PRP and steroids succeeded in treating and decreasing recurrence of the disease. Twenty-four participants with clinically diagnosed as OLP were enrolled in this study. We separated the patients in 2 groups, 12 patients in group A were treated by intralesional PRP every two weeks for 2months or stopped if healing occurred earlier. Group B (12 patients) treated by intralesional Triamcinolone Acetonide (TA) (20 mg) every two weeks for 2months or may be less if healing occurred earlier. The response of OLP lesions to treatment was evaluated by reduction of lesional areas, REU scores, and NRS scores. The patients with complete response (CR; 80%-100% reduction in the lesion area) were followed for 3months biweekly. There was a statistically significant decrease in REU and pain score in both groups after treatment compared to before. There was a statistically increase in frequency of side effects among patients received PRP especially pain compared to those treated by steroid. Also, recurrence of the disease after treatment during follow-up for 3months was more significant among patients treated by PRP. Intralesional PRP is a good and safe modality for treatment of OLP and intralesional TA. However, there were some side effects and recurrence of disease after follow-up for three months in patients treated by PRP more than those treated by TA.

Multi-Modality Treatment of Supraglottic Stenosis Secondary to Laryngeal Pemphigus: Sharing Experience in UiTM

Supraglottic stenosis is a rare subsite of laryngotracheal stenosis. In the literature, the common causes of supraglottic stenosis are radiation therapy or autoimmune disease. We present an experience in dealing with supraglottic stenosis secondary to laryngeal pemphigus. This is a case of a 36-year-old lady with supraglottic stenosis secondary to laryngeal pemphigus. She presented to our clinic with shortness of breath and mild stridor mainly on exertion. An office-based procedure of trans-nasal scope-guided with serial intralesional steroid injections (SILSI) using single-use Olympus Injector Force Injection Needles Max 23G, was done which halted the progression of the disease. Eventually, balloon dilatation under jet ventilation was performed to widen the size of the stenosis and reduce the symptoms. Dilatation was performed using CRE PRO Wire-guided balloon dilatation catheter from size 8mm to 12mm with respective pressure applied for about 2 minutes without interruption of spontaneous breathing, oxygenation, or ventilation. Incision of stenosis segment with micro scissor was performed in between balloon dilatation and the procedure was completed with intralesional steroid injections. Upon follow-up, we noted clinical improvement of the stenosis as well as the patient’s health perception as measured by EQ-5D-5L. Patients with supraglottic stenosis usually need tracheostomy for breathing. This multimodality treatment might be required to treat supraglottic stenosis. Endoscopic treatment can result in favourable outcomes for the patient without needing a tracheostomy. International Journal of Human and Health Sciences Supplementary Issue: 2023 Page: S25

Treatments for early-stage Dupuytren's disease: an evidence-based approach.

Current treatments for Dupuytren's disease are limited to late-stage disease when patients have developed flexion contractures and have impaired hand function. They all have limitations, including the risk of recurrence and complications. The use of treatments for early-stage disease, such as intralesional steroid injections or radiotherapy which lack a clear biological basis or evidence of effectiveness based robust randomized, double blind, placebo-controlled trials, highlights the desire of patients to access treatments before they develop significant flexion contractures. A detailed understanding of the cellular landscape and molecular signalling in nodules of early-stage disease would permit the identification of potential therapeutic targets. This approach led to the identification of tumour necrosis factor (TNF) as a target. A phase 2a clinical trial identified 40 mg in 0.4 mL adalimumab as the most efficacious dose and a subsequent randomized, double blind, placebo-controlled phase 2b trial showed that four intranodular injections at 3-month intervals resulted in decrease in nodule hardness and size on ultrasound scan at 12 months, and both parameters continued to decrease further at 18 months, 9 months after the final injection. This type of approach provides clinicians with a robust evidence base for advising their patients.

Intralesional Steroid Injection Versus Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Comparative, Prospective, Case Series Study.

Background This study aimed to compare and evaluate the outcomes of intralesional steroid injections (ultrasound-guided) versus extracorporeal shockwave therapy in the treatment of plantar fasciitis. Methodology Between January 2021 and March 2022, 120 (84 male, 36 female) patients with a confirmed diagnosis of plantar fasciitis were identified. Subjective assessment was done using Mayo Clinical Score, and objective evaluation was done by measuring plantar fascia thickness using ultrasonography. For this study, two groups were made, wherein group A was administered a high dose of extracorporeal shockwave therapy, and group B was administered ultrasound-guided intralesional or local steroid injections. Results Plantar fascia thickness was considerably reduced after therapy in both groups; however, the difference in thickness reduction was not statistically significant between both groups. Mayo Clinic Scores showed statistically significant improvement in pain; however, the difference in pain reduction was not statistically significant between both groups. Conclusions A considerable clinical and radiological improvement was noted in both groups; however, we did not record statistically significant and superior results in either group. Intralesional steroid injections provided faster clinical improvement and better patient compliance.

Efficacy of Curcumin in the Management of Oral Submucous Fibrosis - An Intervention Study

Background and Objective: Oral submucous fibrosis (OSMF), a chronic, inflammatory, and potentially malignant disorder of the oral cavity, has been linked to the chewing of arecanuts. Antioxidants and quitting habits ought to both be incorporated into OSMF therapeutic interventions regimens. Current study aimed to determine curcumin’s efficacy as an antioxidant in the management of OSMF. Materials and Methods: In this intervention study, 42 participants with OSMF were allocated into three groups. Group A received curcumin; group B received intralesional steroid injections; and group C received neither treatment (placebo group). For three months, groups A and B received twice-daily doses of 400 mg of curcumin each, while group C received twice-daily doses of placebo capsules. Group B also received biweekly intralesional steroid injections of 4 mg/ml of betamethasone. Data were analyzed using statistical tests. Results: After receiving interventions, group B patients showed clinically significant improvements in mouth opening. Both Group A and B reported a burning sensation reduction that was statistically significant. Statistically, greater improvement in mouth opening and a decrease in burning sensation were reported in group A. Conclusion: When employed as a combination therapy in the initial management of people with OSMF, curcumin can help patients with their clinical symptoms. Future research is recommended to use larger samples and longer treatment follow-up periods.

Combined intralesional platelet-rich plasma and intralesional steroid versus intralesional steroid alone in the treatment of alopecia areata

Background Platelet-rich plasma (PRP) is a promising treatment method of alopecia, but there is a debate about its role in the treatment of alopecia areata. Intralesional steroid is the first-line treatment option for patchy alopecia areata. Combination therapy represents an option for increasing the efficacy of the different lines of treatment.Objective To compare the therapeutic efficacy of traditional treatment of alopecia areata with intralesional injection of triamcinolone acetonide versus combination therapy with intralesional triamcinolone acetonide and intralesional PRP alternatively.Patients and methods In this comparative randomized single-blinded study, 30 patients with two nonadjacent patches of alopecia areata were included. One patch was treated with intralesional triamcinolone acetonide alone (group I) every 4 weeks for 3 months, and the other patch was treated with intralesional triamcinolone acetonide alternating with intralesional PRP (group II) every 2 weeks for 3 months. Evaluation was done by MacDonald Hull and Norris grading and dermoscopy.Results A significant increase in the mean grading score was noted before each intralesional steroid injection session in both groups. However, group II patches treated with intralesional triamcinolone acetonide alternating with intralesional PRP showed significantly higher mean grading score as compared with group I patches treated with intralesional triamcinolone acetonide alone. The dermoscopic features of alopecia areata significantly decrease or disappear at the end of treatment sessions in both groups.Conclusion Combined use of intralesional steroid and intralesional PRP in the treatment of alopecia areata yields better results than using intralesional steroid alone and could be considered as a more effective line of treatment. However, further research studies are needed to determine the optimal dose, intervals, and duration of treatment.

Analysis of the Effect of Intralesional Steroid Injection on the Voice During Laryngeal Microsurgery

Background and Objectives Vocal fold (VF) scar is known to be the most common cause of dysphonia after laryngeal microsurgery (LMS). Steroids reduce postoperative scar formation by inhibiting inflammation and collagen deposition. However, the clinical evidence of whether steroids are helpful in reducing VF scar formation after LMS is still lacking. The purpose of this study is to determine whether intralesional VF steroid injection after LMS helps to reduce postoperative scar formation and voice quality.Materials and Method This study was conducted on 80 patients who underwent LMS for VF polyp, Reinke’s edema, and leukoplakia. Among them, 40 patients who underwent VF steroid injection after LMS were set as the injection group, and patients who had similar sex, age, and lesion size and who underwent LMS alone were set as the control group. In each group, stroboscopy, multi-dimensional voice program, Aerophone II, and voice handicap index (VHI) were performed before and 1 month after surgery, and the results were statistically analyzed.Results There were no statistically significant differences in the distribution of sex, age, symptom duration, occupation and smoking status between each group. Both groups consisted of VF polyp (n=21), Reinke’s edema (n=11), and leukoplakia (n=9). On stroboscopy, the lesion disappeared after surgery, and the amplitude and mucosal wave were symmetrical on both sides of the VFs in all patients. Acoustic parameters and VHI significantly improved after surgery in all patients. However, there was no significant difference between the injection and control group in most of the results.Conclusion There was no significant difference in the results of stroboscopy, acoustic, aerodynamic, and subjective evaluation before and after surgery in the injection group and the control group.

Revisiting the Role of Local Cryotherapy for Acne Treatment: A Review and Update

Acne vulgaris is a well-recognized condition among adolescents and adults that adversely affects their quality of life. Local cryotherapy has long been reported to be effective in treating acne vulgaris, inducing a more rapid involution of acne than topical medications. However, the use of cryotherapy has been limited for acne treatment due to several drawbacks, including procedural pain and pigmentary alterations. Currently, newer cryotherapy devices are gaining attention in dermatology due to their ability to monitor and precisely control the target temperature. In this narrative review, a brief history and the latest update on acne cryotherapy will be presented. Additionally, a special emphasis is placed on the role of cryotherapy, alone or in combination with intralesional steroid injections for nodulocystic acne.

Seroma of Auricle.

The pseudocyst of the auricle is an intracartilaginous lesion defined as the accumulation of sterile, straw-coloured fluid in a cyst unlined by epithelium. It is more common in males. The most common site of lesion is the scaphoid fossa and right ear. Though the aetiology remains unclear, it may be associated with mechanical irritation, repeated minor injuries and chronic trauma. If left untreated, it can lead to permanent deformity of the auricle. Pseudocyst of the auricle is a rare and challenging condition. Medical management has unfortunately shown no practical results. Hence, surgical treatment modalities are the best option. The universal aim of treatment is the conservation and restoration of the anatomical structure of the pinna, removal of cystic lesions and prevention of recurrence. Simple aspiration or incision and drainage alone lead to reaccumulation of cystic fluid in most cases. The technique of incision and drainage is the easiest but has a high recurrence rate. Conservative treatment often results in recurrence and unsatisfactory results. Other treatment modalities include incision and drainage with daily irrigation, auricular splinting, aspiration with intralesional steroid injection, aspiration followed by compression dressing, or aspiration with intralesional steroid injection followed by compression dressing and surgical deroofing, surgical deroofing followed by compression with buttons or sheet or sandwich method. Cysts with a diameter less than 1 cm are dealt with through non-surgical treatment modalities, while for cysts having a diameter greater than 1 cm, surgery is considered as first choice therapy. These treatment options have shown promising results. Various modifications in the traditional techniques have reduced the recurrence rate, successfully treated the condition and shown good cosmetic results. This review article aims at providing a holistic collection of various conventional treatment modalities and novel modifications introduced, which can be used in a sequence of definitive treatments of seroma of the auricle.

Intensive endoscopic therapy for untreated cervical anastomotic strictures after esophagectomy: a pilot study.

Cervical anastomotic strictures after esophagectomy cause significant disease burden. We aimed to study the technical feasibility and safety of intensive endoscopic therapy. In this pilot study, we included 15 patients with an untreated benign cervical anastomotic stricture after esophagectomy. Intensive endoscopic therapy comprised three endoscopic modalities: in- and excision using a needle-knife, intralesional steroid injections and bougie dilation. In two endoscopic procedures, the stricture was dilated up to a luminal diameter of 18mm. Patients were followed up to 6months. A luminal diameter of 18mm was achieved in 13 of 15 patients (87%) after two endoscopic procedures. No major adverse events related to the investigational treatment occurred. Median dysphagia scores significantly improved from 2 (IQR, interquartile range, 2-3) at baseline to 0 (IQR 0-1) after 14days (p < 0.001). Eleven (73%) patients developed recurrent symptoms of dysphagia requiring a median of 1 (IQR 0-3) additional endoscopic dilation procedure. Achieving a luminal diameter of 18mm in two procedures with intensive endoscopic therapy was technically feasible and effective in reducing dysphagia rapidly in patients with a cervical anastomotic stricture after esophagectomy. No major adverse events related to the investigational treatment were observed.

S2259 The Efficacy and Safety of Treatment Outcomes for Refractory Benign Esophageal Strictures Using a Novel Combination of Needle-Knife Stricturoplasty, Balloon Dilation, and Steroid Injection

Introduction: Benign esophageal strictures that are refractory to standard endoscopic techniques can significantly impair a patient’s quality of life leading to complications such as malnutrition and weight loss. When repeat dilations fail to achieve an adequate luminal diameter or resolve dysphagia, further therapy with needle knife or steroid injections are needed. However, patients can still clinically fail. In an effort to manage such strictures we employed a novel triple combination of needle-knife stricturoplasty, balloon dilation, and steroid injection to assess clinical outcomes and safety. Case Description/Methods: This was a single center retrospective study of all adult patients with benign strictures that were refractory to conventional endoscopic therapy and removable self-expanding metal stenting. The triple therapy consisted of at least 4 longitudinal needle knife incision followed by balloon dilation and then targeted 4 quadrant intralesional steroid injections (Figure). Primary success was defined as a 50% reduction in repeat endoscopic therapy needed. Secondary outcomes included periodic dilation index, esophageal diameter changes, technical success, and complications. Four patients (average age 49.7 years, average body mass index 22.8 kg/m2) underwent endoscopic therapy for complex benign strictures using our triple therapy technique (Table). Stricture etiologies included peptic strictures (n= 3) and an anastomotic stricture (n=1). All patients previously required esophageal stenting (range 1-3). There was 100% technical success rate with no adverse events. The average diameter of the esophagus before and after triple therapy was 4.2 ± 1.63 mm and 13 ± 1.36 mm, respectively. The periodic dilation index was 6.3 (range 12-2) before and 1.5 (range 5–0) after triple therapy. The mean length of follow up was 316 days (range 116-425). Discussion: Triple combination therapy may be useful in benign strictures that are refractory to standard techniques. We do recommend needle knife before dilation to enhance the efficacy of steroid injections. In light of our findings, this method should be considered when strictures are refractory after 2-3 dilation sessions and/or stent therapy. Larger studies are needed to validate these findings and identify predictive factors that can enhance clinical success using this novel combination.Figure 1.: Esophageal stricture (A) that was treated with needle knife (B), balloon dilation (C) and then steroid injections (D). Table 1. - Patient characteristics and clinical outcomes Patient Age/Sex Stricture Etiology Initial stricture diameter Stricture diameter after triple therapy Number of triple therapy procedures Length of follow up (days) 1 30/Male GERD 7 mm 13.5 mm 1 425 2 59/Male Anastomotic 3 mm 15 mm 2 421 3 57/Male GERD 3 mm 11.5 mm 4 304 4 53/Male GERD 4 mm 12 mm 2 116

Comparison of Intralesional Triamcinolone Acetonide Injection versus Surgical Intervention for Management of Primary Chalazion

Purpose: To compare the effectiveness of intralesional steroid injection versus Incision and curettage in management of primary chalazion. Study Design: Quasi experimental study. Place and Duration of Study: Department of Ophthalmology, Pakistan Institute of Medical Sciences, Islamabad, from August 2020 to January 2021. Methods: Eighty patients were divided into two groups of 40 each through consecutive sampling. Patients with primary chalazion of the size &gt;5mm, age group 18 to 50 years and either gender were included. Patients with recurrent, multiple and infected chalazia were excluded. All patients underwent complete ocular examination. Group A underwent Incision and curettage while in group B a 28 gauge needle with a 1 ml syringe was used to inject 0.25 ml of 40 mg/ml Triamcinolone Acetonide into the chalazion via transcutaneous route. Success was defined as 80% reduction in the size of chalazion after one month. The chi-square test was used for equivalence of treatment efficacy between the groups. Results: Age range in this study was 18 to 50 years. Mean age was 34.10 ± 5.87 years in Group A and 35.975 ± 7.60 years in Group B. The procedure was successful in 31 (77.5%) individuals in group A and 33 (82.5%) individuals in group B (P = 0.576), which was statistically insignificant. Stratification with respect to gender and age also showed no statistically significant difference between the two groups (p &gt; 0.05). Conclusion: Intralesional steroid injection and Incision/curettageare equally effective in management of primary chalazion.

The Effect of Subglottic Steroid injection on Blood Glucose in a Cohort of Patients With Subglottic Stenosis.

The objective of this work was to assess the effect of a single intralesional subglottic steroid injection on fasting blood glucose over 7 days in a cohort of patients with subglottic stenosis. A prospective cohort study of patients undergoing intralesional steroid injections at a tertiary academic center. Patients had baseline bloodwork performed, including fasting blood glucose (FBG), and hemoglobin A1C levels. Demographic data and risk factors were collected. Fasting capillary glucose (FCG) was measured using a capillary glucometer and performed by patients daily from days 0 to 7 after a single injection of Triamcinolone into the subglottic airway. Data were analyzed using descriptive and comparative statistics. Eleven patients were enrolled, and 10 completed data collection over 7 days. All were female, with a mean age of 52.6 years (SD 17.5). Two patients were diabetic (non-insulin dependent). There was a statistically significant increase in FCG on day 1 post-injection (mean=122.4 mg/dl compared to 100.7 mg/dl) that normalized for all patients within 24-72 h. The mean increase in FCG was 21.5% (SD 22.5%) of the initial value for the cohort. The diabetic group had statistically significant higher glucose values on day 1 compared to the non-diabetic group (146.5 mg/dl compared to 117.0 mg/dl). A single subglottic steroid injection appears to cause a transient increase in FCG 1 day post injection, which resolves after 24-72 h and can be more pronounced in diabetic patients. 4 Laryngoscope, 133:1590-1594, 2023.

Judicious management of pinna keloids: our experience with combination therapy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Keloids occur as a result of overgrowth of fibrous tissue following healing of a cutaneous injury and they cause aesthetic issues when they appear on the exposed parts of the body, especially the face. Keloids are difficult to treat, with a high recurrence rate. There are several treatment modalities for management of keloids, though no single modality is completely effective. Most commonly used treatment modalities are intra-lesional steroids, surgical excision, pressure application, silicone gel sheets, 5-fluorouracil (5-FU), cryotherapy, radiation therapy, laser therapy or a combination of these modalities. The aim of the study was to analyse the causes of development of keloids on the pinna and evaluated the outcomes of various treatment modalities applied. It focused on assessing the clinical efficacy of combined surgical excision of pinna keloids with serial steroid injections to prevent recurrence, in comparison to monotherapy with intra-lesional steroid injections alone.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective review based on medical records was done for 18 patients with keloid of pinna, who were treated with either monotherapy or combination therapy. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Satisfactory low recurrence rates were observed with meticulous surgical excision followed by serial steroid injections (18.2%), as compared to monotherapy with serial steroid injections alone (71.4%), and these comparative results were statistically significant at p&amp;lt;0.05 in the cohort.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; A judicious plan for management for pinna keloids is necessary in order to achieve the best functional and cosmetic outcomes, while reducing the recurrence rates to a minimum. Following a combination of interventions has proved safe and effective for managing this challenging entity.&lt;/p&gt;