Comparison of intralesional triamcinolone acetonide alone and with 5 -fluorouracil for the treatment of keloids

Abstract

Objective: To compare the efficacy of intralesional triamcinolone acetonide alone and in combination with 5 -fluorouracil in the management of keloids.

Method: The prospective cross-sectional study was conducted at the Dermatology outpatient department, Ojha campus, Dow University of Health Sciences, Karachi, from April to September 2023, and comprised patients with keloids who were divided into group A receiving intralesional triamcinolone acetonide 40mg/ml alone, and group B receiving a combination of triamcinolone acetonide 40mg/ml and 5-fluorouracil 50mg/ml. The medication was given monthly for 6 months, and efficacy was assessed using the Vancouver Scar Scale on each visit before the injection. Data was analysed 26.

Results: Of the 66 patients, 33(50%) were in group A; 19(57.6%) females and 14(42.4%) males with mean age 34.39±9.81 years. There were 33(50%) patients in group B; 20(60.6%) females and 13(39.4%) males with mean age 33.75±11.51 years. In group B, good to excellent response was seen in 31 (95%) cases compared to 23 (70%) in group A. Side effects such as atrophy (3 cases, 9.1%) and telangiectasia (2 cases, 6.1%) were more prevalent in Group A compared to atrophy (1 case, 3%) and telangiectasia (1 case, 3%) in Group B.

Conclusion: Intralesional triamcinolone acetonide in combination with 5-fluorouracil was found to be more effective with faster response and less side-effects compared to triamcinolone acetonide alone.

Key Words: Keloid, 5-fluorouracil, Triamcinolone acetonide, Vancouver scar scale.