Treatment Approach to Non-responsive Keloid: Our Experience
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Abstract
Keloids are abnormal scars, which are extremely distressing for the patients. Pain and itching are the two most cumbersome complaints which affect a patient’s life in multiple ways. Keloids are irregular growth, which looks ugly, if present over exposed areas. Cosmetic, physiological and psychosocial aspects are compromised and patients avoid social gatherings and may undergo severe depression. Although there are multiple treatment modalities for keloids like intralesional injections of steroids, cytotoxic drugs, cryotherapy, radiation therapy, surgical excision, etc., but no modality is proven to be superior and effective. However intralesional injection of triamcinolone acetonide is widely practiced. Triamcenolone acetonide might not be effective, since many patients return with complaints of recurrence, non-responsiveness or unsatisfactory response. The present study shows a series of patients who underwent intralesional injection of triamcinolone acetonide but they did not respond to it. We combined intralesional injection of triamcinolone acetonide along with 5-FU. The response was satisfactory and significant improvement was noticed.
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References
Niessen FB, Spauwen PH, Schalkwijk J, Kon M. On the nature of hypertrophic scars and keloids: a review. Plast Reconstr Surg. 1999;104(5):1435-58. doi: 10.1097/00006534-199910000-00031.
Halim AS, Emami A, Salahshourifar I, Kannan TP. Keloid scarring: understanding the genetic basis, advances, and prospects. Arch Plast Surg. 2012 May;39(3):184-9.
Bock O, Schmid-Ott G, Malewski P, Mrowietz U. Quality of life of patients with keloid and hypertrophic scarring. Arch Dermatol Res 2006;297:433–38.
Leventhal D, Furr M, Reiter D. Treatment of keloids and hypertrophic scars: a meta-analysis and review of the literature. Arch Facial Plast Surg. 2006;8(6):362-8.
Brown BC, McKenna SP, Siddhi K, McGrouther DA, Bayat A. The hidden cost of skin scars: quality of life after skin scarring. J Plast Reconstr Aesthet Surg 2008;61:1049–58.
Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG. Hypertrophic scarring and keloids: Pathomechanisms and current and emerging treatment strategies. Mol Med 2011;17:113–25.
Ojeh N, Bharatha A, Gaur U, Forde AL. Keloids: Cur rent and emerging therapies. Scars Burn Heal 2020;6:2059513120940499.
Nanda S, Reddy BS. Intralesional 5-fluorouracil as a treatment modality of keloids. Dermatol Surg 2004;30:54–56.
Sharma S, Bassi R, Gupta A. Treatment of small keloids with intralesional 5-f luorouracil alone vs. intralesional triamcinolone acetonide with 5-f luorouracil. J Pak Assoc Dermatol. 2017;22(1):35-40.
Baryza MJ, Baryza GA. The Vancouver Scar Scale: an administration tool and its interrater reliability. J Burn Care Rehabil. 1995;16(5):535-538.
Draaijers LJ, Tempelman FR, Botman YA, et al. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg. 2004;113:1960-1965
Ren Y, Zhou X, Wei Z, Lin W, Fan B, Feng S. Efficacy and safety of triamcinolone acetonide alone and in combination with 5-fluorouracil for treating hypertrophic scars and keloids: a systematic review and meta-analysis. Int Wound J, 14(3): 480-487.
Darougheh A, Asilian A, Shariati F. Intralesional triamcinolone alone or in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. Clin Exp Dermatol 2009;34:219–23.
Saha AK, Mukhopadhyay M. A comparative clinical study on role of 5-Flurouracil versus triamcinolone in the treatment of keloids. Indian J Surg 2012;74:326–9.
Khan MA, Bashir MM, Khan FA. Intralesional triamcinolone alone and in combination with 5-f luorouracil for the treatment of keloid and hypertrophic scars. J Pak Med Assoc. 2014;64(9):1003-7.
Kumar S, Kumar P, Asif S, Pandey S. Comparative study of combination of intralesional triamcinolone acetate with 5-fluorouracil versus triamcinolone alone in treatment of keloid. Int J Recent Sur Med Sci doi: 10.25259/IJRSMS-2022-2-16