Comparison of efficacy of intralesional 5-Flourouracil plus triamcinolone acetonide verses intralesional triamcinolone acetonide alone in the treatment of keloids
Keywords:Keloid, 5-Flurouracil, triamcinolone acetonide
AbstractBackground Keloid is a benign well demarcated area of dense, fibrous tissue overgrowth that extends beyond the original defect. It is a result of an overgrowth of granulation tissue at the site of a healed skin injury. A variety of treatment regimens have been used for the management of keloids but none proved satisfactory. Methods A total of 150 patients (75 in each group), fulfilling inclusion and exclusion criteria, were included in the study after taking informed consent. Local anesthesia was given in the form of injection lignocaine sublesionally in both groups. In group A, injection 5-flurouracil 10mg/ml (0.2ml) plus triamcinolone acetonide 10mg/ml (0.25ml) was given intralesionally, 2mm apart. In group B, injections triamcinolone acetonide 10mg/ml (0.25ml) alone was given intralesionally, 2mm apart. These injections were repeated after 3 weeks in each group for a duration of 3 months. Photographs were taken at base line and the end of 14th week. Efficacy was measured in terms of >75% reduction in size of keloids (measured by a dialed caliper) from baseline till the end of 14 weeks. Results Efficacy was achieved in 55% (n=43) of patients in group A and was achieved in 36% (n=27) of patients in group B. The difference in efficacy of both groups was statistically significant with p value of 0.00. Conclusion We concluded that the efficacy of intralesional 5-flurouracil plus triamcinolone acetonide is significantly higher than intralesional triamcinolone acetonide alone for the treatment of keloids.
Ketchum LD. Hypertrophic scars and keloids. Clin Plast Surg. 1977;4:301-10.
Oluwasanmi JO. Keloids in the African. Clin Plast Surg. 1974;1:179-95.
Sadeghinia A, Sadeghinia S. Comparison of the efficacy of intralesional triamcinolone acetonide and 5-fluorouracil tatooing for the treatment of keloids. Dermatol Surg. 2012;38:104-9.
Khan MA, Bashir MM, Khan FA. Intralesional triamcinolone alone and in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. J Pak Med Assoc. 2014;64(9):1003-7.
Alhady SM, Sivanantharajah K. Keloids in various races: A review of 175 cases. Plast Reconstr Surg. 1969;44(6):564-6.
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. 2007;34:219-3.
Mutalik S. Treatment of keloids and hypertrophic scars. Ind J Dermatol Venereol Leprol. 2005;71:3-8.
Asilian A, Darougheh A, Shariati F. New combination of triamcinolone, 5-fluorouracil and pulsed-dye laser for treatment of Keloid and hypertrophic scars. Dermatol Surg. 2006;32:907-5.
Sharma S, Bassi R, Gupta A. Treatment of small keloids with intralesional 5-fluorouracil alone vs intralesional triamcinolone acetonoid with 5-fluorouracil. J Pak Assoc Dermatol. 2012;22:35-40.
Al-Attar A, Mess S, Thomassen JM, Kauffman CL, Davison SP. Keloid pathogenesis and treatment. Plast Reconstr Surg. 2006;117:286-300.
Bulstrode NW, Mudera V, McGrouther DA, Grobbelaar AO, Cambrey AD. 5-fluorouracil selectivity inhibits collagen synthesis. Plast Reconstr Surg. 2005;116:209-21.
Gupta S, Kalra A. Efficacy and safety of intralesional 5-fluorouracil in the treatment of keloids. Dermatology. 2002;204:130-2.
Wu XL, Liu W, Cao YL. Clinical study on keloid treatment with intralesional injection of low concentration 5-fluorouracil. Zhonghua Zheng Xing Wai Ke Za Zhi. 2006;22:44-6.
Davison SP, Dayan JH, Clemens MW, Sonni S, Wang A, Crane A. Efficacy of intralesional 5-fluorouracil and triamcinolone in the treatment of keloids. Aesthet Surg J. 2009;29:40-6.
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.