COMPARISON OF THE EFFICACY OF INTRALESIONAL 5% FU VERSUS INTRALESIONAL TRIAMCINOLONE IN PATIENTS PRESENTING WITH KELOID AND HYPERTROPHIC SCAR AT TERTIARY CARE HOSPITAL, KARACHI

Authors

  • B SHAH Department of Dermatology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
  • R GHAFOOR Department of Dermatology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
  • N ASAD Department of Dermatology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
  • A SAMEE Department of Dermatology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
  • M SURHIYO Department of Dermatology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
  • A SATTAR Department of Dermatology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.751

Keywords:

5-Fluorouracil, Triamcinolone, Keloid, Hypertrophic Scar

Abstract

Despite the fact that keloids and hypertrophic scars are frequent benign hyper-proliferative growths of dermal fibroblasts, the clinical concerns, such as physical and psychological issues, are serious and impairing, and there are few effective therapies. Although 5-fluorouracil (5-FU) and intralesional triamcinolone acetonide (TAC) are widely used to manage both scars, their effectiveness is still debatable. To compare the efficacy of intralesional 5% FU versus intralesional triamcinolone in patients presenting with keloid and hypertrophic scar at Tertiary Care Hospital, Karachi. This RCT study was conducted on patients presenting with keloid and hypertrophic scars at the Outpatient Department of Dermatology, JPMC, Karachi, meeting inclusion criteria. A brief history of demographic information and written informed consent were taken from each patient. A total of 158 patients were enrolled in the study and were randomly allocated to Group A, Intralesional triamcinolone group, and B: Intralesional 5% FU group twice weekly for a total of 4 sessions. During each visit, the keloid height was measured, photographed again, and documented. Efficacy was labeled if patients with keloid and hypertrophic scar in either group showed ≥ 50% reduction in height. Comparison of efficacy between groups showed a significant difference as the efficacy rate was higher in patients treated with 5-FU 45mg as compared to the patients administrated with TAC 10mg (70.9% vs. 50.6%; P-value=0.009). This analysis revealed that irrespective of the patient's age, sex, illness duration, or lesion site, intra-lesional 5-fluorouracil (5-FU) offered the significant benefit of a faster and more effective response than triamcinolone (TAC) in the treatment of keloids and hypertrophic scars.

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References

Ali, K., Tayyaba, F., and Tabassum, H. M. (2016). Comparison between the efficacy of intra-lesional triamcinolone and a combination of triamcinolone with 5-fluorouracil in treating keloid and hypertrophic scars. Pakistan J Med Heal Sci 10, 578-581.

Berman, B., Maderal, A., and Raphael, B. (2017). Keloids and Hypertrophic Scars: Pathophysiology, Classification, and Treatment. Dermatol Surg 43 Suppl 1, S3-s18.

Betarbet, U., and Blalock, T. W. (2020). Keloids: A Review of Etiology, Prevention, and Treatment. J Clin Aesthet Dermatol 13, 33-43.

Bijlard, E., Steltenpool, S., and Niessen, F. B. (2015). Intralesional 5-fluorouracil in keloid treatment: a systematic review. Acta Derm Venereol 95, 778-82.

Cavalié, M., Sillard, L., Montaudié, H., Bahadoran, P., Lacour, J. P., and Passeron, T. (2015). Treatment of keloids with laser-assisted topical steroid delivery: a retrospective study of 23 cases. Dermatol Ther 28, 74-8.

Darougheh, A., Asilian, A., and Shariati, F. (2009). Intralesional triamcinolone alone or in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. Clin Exp Dermatol 34, 219-23.

Elsaie, M. L. (2021). Update on management of keloid and hypertrophic scars: a systemic review. Journal of cosmetic dermatology 20, 2729-2738.

Hietanen, K., Järvinen, T., Huhtala, H., Tolonen, T., Kuokkanen, H., and Kaartinen, I. (2019a). Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections–a randomized controlled trial. Journal of Plastic, Reconstructive & Aesthetic Surgery 72, 4-11.

Hietanen, K. E., Järvinen, T. A., Huhtala, H., Tolonen, T. T., Kuokkanen, H. O., and Kaartinen, I. S. (2019b). Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections - a randomized controlled trial. J Plast Reconstr Aesthet Surg 72, 4-11.

Ibrahim, A., and Chalhoub, R. S. (2018). 5-fu for problematic scarring: a review of the literature. Ann Burns Fire Disasters 31, 133-137.

Kabel, A. M., Sabry, H. H., Sorour, N. E., and Moharm, F. M. (2016). Comparative study between intralesional injection of bleomycin and 5-fluorouracil in the treatment of keloids and hypertrophic scars. Journal of Dermatology & Dermatologic Surgery 20, 32-38.

Kim, S. W. (2021). Management of keloid scars: noninvasive and invasive treatments. Arch Plast Surg 48, 149-157.

Klomparens, K., and Simman, R. (2022). Treatment of Keloids: A Meta-analysis of Intralesional Triamcinolone, Verapamil, and Their Combination. Plast Reconstr Surg Glob Open 10, e4075.

Lee, Y. I., Kim, J., Yang, C. E., Hong, J. W., Lee, W. J., and Lee, J. H. (2019). Combined therapeutic strategies for keloid treatment. Dermatologic Surgery 45, 802-810.

Limandjaja, G. C., Niessen, F. B., Scheper, R. J., and Gibbs, S. (2020). The keloid disorder: heterogeneity, histopathology, mechanisms and models. Frontiers in cell and developmental biology 8, 360.

Manzoor, H., Tahir, K., Nasir, A., Mufti, S., and Shehzad, A. (2020). Comparison of efficacy of intralesional 5-fluorouracil alone, intralesional triamcinolone acetonide alone and intralesional triamcinolone acetonide with 5-fluorouracil in management of keloids. Journal of Pakistan Association of Dermatologists 30, 282-285.

Monteiro, R. C., Bhat, M. R., Martis, J., and Kamath, H. G. (2022). A Comparative Study of the Efficacy of Intralesional 5 Fluorouracil vs Combination of 5 Fluorouracil with Triamcinolone Acetonide in Keloids. Indian J Dermatol 67, 211-215.

Morelli Coppola, M., Salzillo, R., Segreto, F., and Persichetti, P. (2018). Triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives. Clin Cosmet Investig Dermatol 11, 387-396.

Ogawa, R. (2017). Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis. International journal of molecular sciences 18, 606.

Perdanasari, A. T., Lazzeri, D., Su, W., Xi, W., Zheng, Z., Ke, L., Min, P., Feng, S., Zhang, Y. X., and Persichetti, P. (2014). Recent developments in the use of intralesional injections keloid treatment. Archives of plastic surgery 41, 620-629.

Ren, Y., Zhou, X., Wei, Z., Lin, W., Fan, B., and Feng, S. (2017). 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, 480-487.

Salati, S. A. (2019). Keloids–an extensive review in the light of recent literature. Journal of Pakistan Association of Dermatologists 29, 225-249.

Srivastava, S., Patil, A., Prakash, C., and Kumari, H. (2018). Comparison of Intralesional Triamcinolone Acetonide, 5-Fluorouracil, and Their Combination in Treatment of Keloids. World J Plast Surg 7, 212-219.

Srivastava, S., Patil, A. N., Prakash, C., and Kumari, H. (2017). Comparison of Intralesional Triamcinolone Acetonide, 5-Fluorouracil, and Their Combination for the Treatment of Keloids. Adv Wound Care (New Rochelle) 6, 393-400.

Tripathi, S., Soni, K., Agrawal, P., Gour, V., Mondal, R., and Soni, V. (2020). Hypertrophic scars and keloids: a review and current treatment modalities. Biomedical Dermatology 4, 11.

Urioste, S. S., Arndt, K. A., and Dover, J. S. (1999). Keloids and hypertrophic scars: review and treatment strategies. Semin Cutan Med Surg 18, 159-71.

Walsh, L. A., Wu, E., Pontes, D., Kwan, K. R., Poondru, S., Miller, C. H., and Kundu, R. V. (2023). Keloid treatments: an evidence-based systematic review of recent advances. Systematic Reviews 12, 42.

Wilson, A. M. (2013). Eradication of keloids: Surgical excision followed by a single injection of intralesional 5-fluorouracil and botulinum toxin. Can J Plast Surg 21, 87-91.

Zhuang, Z., Li, Y., and Wei, X. (2021). The safety and efficacy of intralesional triamcinolone acetonide for keloids and hypertrophic scars: A systematic review and meta-analysis. Burns 47, 987-998.

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Published

2024-03-14

How to Cite

SHAH , B., GHAFOOR , R., ASAD , N., SAMEE , A., SURHIYO , M., & SATTAR , A. (2024). COMPARISON OF THE EFFICACY OF INTRALESIONAL 5% FU VERSUS INTRALESIONAL TRIAMCINOLONE IN PATIENTS PRESENTING WITH KELOID AND HYPERTROPHIC SCAR AT TERTIARY CARE HOSPITAL, KARACHI. Biological and Clinical Sciences Research Journal, 2024(1), 751. https://doi.org/10.54112/bcsrj.v2024i1.751

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