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New Combination of Triamcinolone, 5-Fluorouracil, and Pulsed-Dye Laser for the Treatment of Keloid Andhypertrophic Scars



Asilian A1 ; Darougheh A1 ; Shariat F2
Authors
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Authors Affiliations
  1. 1. Skin Diseases and Cutaneous Leishmaniasis Research Center, Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Dermatology, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Isfahan Medical School Published:2012

Abstract

Background: Keloids and hypertrophic scars are benign growths of dermal collagen that usually cause major physical, psychological and cosmetic problems. Methods: In this 12-week single-blinded clinical trial, 69 patients were randomly assigned into three study groups. In Group 1, intralesional triamcinolone acetonide (TAC, 10 mg/mL) was injected at one-week intervals for a total of 8 weeks. In Group 2, 0.1 mL of 40 mg/mL TAC was added to 0.9 mL of 5-Fluorouracil (5FU, 50mg/mL). This combination was injected weekly for 8 weeks. In Group 3, in addition to weekly TAC and 5FU injections for 8 weeks, lesions were irradiated by 585-nm flashlamp-pumped pulsed-dye laser (PDL, 5–7.5 J/cm2) at the 1st, 4th, and 8th weeks. Lesions were assessed for erythema, pruritus, pliability, height, length and width. Findings: Sixty patients completed the study. At the 8- and 12-week follow-up visits, all groups showed improvements in nearly all of the outcome measures; but in comparison between groups, the improvements were statistically more significant in the TAC-5FU and TAC-5FU-PDL groups (P < 0.05 for all outcome measures). At the end of the study, the erythema score was significantly lower, and itch reduction was statistically higher in the TAC-5FU-PDL group (P = 0.05 for both). The percent of the patients who reported good to excellent improvements (50% improvement) were as follows: 20% in Group 1, 55% in Group 2, and 75% in Group 3 (P = 0.05). Good to excellent responses in each group that were reported by a blinded observer were as follows: 15% in Group 1, 40% in Group 2, and 70% in Group 3 (P = 0.05). Atrophy and telangiectasia were seen in 37% of patients in TAC group. Conclusion: Overall efficacy of TAC-5FU was comparable with TAC-5FU-PDL; but the TAC-5FU-PDL combination was better tolerated by the patients and produced better results. Its reducing effect on the erythema of the lesions was also promising. The TAC-5FU-PDL combination seems to be the best approach for treatment of keloid and hypertrophic scars. © 2012, Isfahan University of Medical Sciences(IUMS). All rights reserved.
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