Intralesional Injection of Triamcinolone Acetonide Alone versus Triamcinolone Acetonide in Combination With 5-Flurouracil in Treatment of Keloid / A Randomised Comparative Clinical Study

Background: Keloid is an abnormal fibrous tissue overgrowth that spreads beyond the original wound margins. In spite of the availability of multiple therapeutic modalities, keloid management is still a challenge for healthcare professionals due to the high recurrence rates.
Aim: To evaluate the efficacy of intralesional injection (ILI) of triamcinolone acetonide (TAC) alone versus its combination with 5flurouracil (5FU) in treatment of keloid and to evaluate side effects of each modality.
Patients and Methods: This study included 186 participants with keloid due to different causes. The cases were randomly assigned into two groups, group 1 (that included 93 patients received intralesional combination of TAC and 5FU) and group 2 (that included 93 cases received intralesional TAC alone). All cases were examined before each injection and a final assessment was conducted thirteen weeks following first dose using Vancouver Scar Scale (VSS), Verbal Rating Scale (VRS), pain, itching and patients’ satisfaction.
Results: Mean VSS in group 1 was statistically significantly diminished than that in group 2 during the follow-up. Regarding pain and itching, there was insignificant difference between both groups during the follow-up. Regarding patient satisfaction, (96.8%) of group 1, and (92.5%) of group 2 were satisfied. Regarding side effects, ulcer was significantly higher in group 1 while hypopigmentation was significantly increased in group 2.
Conclusion: Combination of both TAC and 5FU were demonstrated to be effective in keloid management due to different causes.