KELOID DISEASE: COMPARISON OF TREATMENT WITH INTRALESIONAL TRIAMCINOLONE ACETONIDE, 5-FLUOROURACIL, CRYOTHERAPY AND THEIR COMBINATION

Abstract

Background: Documentation of the efficacy of the modalities of keloid treatment and which of these is the best option is rare. Documentation of the treatment outcomes is also rare. The study aimed to document and compare the treatment outcome of keloid using different modalities of treatment.

Methods: This prospective longitudinal study was conducted on 32 patients diagnosed to have keloid. Patients were randomized into 4 different arms of treatment (Intralesional triamcinolone acetonide only [IL TAC 40mg/ml]; IL TAC (0.1ml) plus 5-Fluorouracil (0.9ml); Cryotherapy only; and Cryotherapy plus IL TAC (40mg/ml), and treated every 4 weeks. The size of each keloid was evaluated before and at the end of the study. Data were analyzed using SPSS version 23.0

Results: The patients were 53.1% female with a mean ± SD age of 32.47 ± 13.93years and an age range of 16-67 years. The mean ±SD volume of keloid reduced from 3.53±1.56 to 0.29±0.15 with no significant difference in volume reduction when the different modalities of treatment were compared, p=0.869. There were no adverse effects in 50%, while 34% had ulcerations 12.5% had hypopigmentation and 3.1% had hyperpigmentation.

Conclusion: All the modalities of treatment were effective in the management of keloid. However, cryotherapy-only results in a faster volume reduction. Two to five sessions of treatment are required for keloid treatment. Ulceration and hypopigmentation should be anticipated in some patients.

Keywords: Keloid, Keloid treatment, triamcinolone acetonide, 5-fluorouracil, cryotherapy.