Garg Gaurav A, Sao Prajct P, Khopkar Uday S
Department of Dermatology, Seth GS Medical College and KEM Hospital, Mumbai, India.
J Cutan Aesthet Surg. 2011 Jan;4(1):2-6. doi: 10.4103/0974-2077.79176.
Keloid is a difficult-to-treat condition and an ideal treatment modality is not available. Carbon dioxide (CO(2)) laser is one of the modalities to treat keloids.
To evaluate the effect of CO(2) laser ablation followed by intralesional steroids on keloids.
This was a prospective, single-center, uncontrolled, open study.
Twenty-eight patients having 35 keloids were included in the study. Keloids were ablated or excised with CO(2) laser followed by intralesional steroid 3-4 weeks apart for 6 months. Results were evaluated after 6 months of stopping of intralesional steroids.
Fisher's exact test was applied for obtaining difference in recurrence rate of regular and irregular patients.
Thirteen patients followed up regularly for intralesional steroids. During 6 months of follow-up after stoppage of steroids, only two patients showed recurrence. Ten patients were irregular for intralesional steroids and seven of them showed recurrence. Difference in recurrence rate of regular and irregular patients was significant.
Only CO(2) laser ablation is not sufficient for halting the pathogenesis of keloid formation.We therefore conclude that CO(2) laser followed by intralesional steroid is a useful therapeutic approach for the treatment of keloids; however, patients need to be observed for recurrence over the next 1 year.
瘢痕疙瘩是一种难以治疗的病症，目前尚无理想的治疗方式。二氧化碳（CO₂）激光是治疗瘢痕疙瘩的方式之一。
评估二氧化碳激光消融联合病灶内注射类固醇对瘢痕疙瘩的治疗效果。
这是一项前瞻性、单中心、非对照、开放性研究。
本研究纳入了28例患有35个瘢痕疙瘩的患者。使用二氧化碳激光对瘢痕疙瘩进行消融或切除，随后每隔3 - 4周进行一次病灶内注射类固醇，持续6个月。在停止病灶内注射类固醇6个月后评估结果。
采用Fisher精确检验来获取规律随访和不规律随访患者复发率的差异。
13例患者规律随访病灶内注射类固醇情况。在停止注射类固醇后的6个月随访期间，仅有2例患者出现复发。10例患者不规律随访病灶内注射类固醇情况，其中7例出现复发。规律随访和不规律随访患者的复发率差异显著。
仅用二氧化碳激光消融不足以阻止瘢痕疙瘩形成的发病机制。因此，我们得出结论，二氧化碳激光联合病灶内注射类固醇是治疗瘢痕疙瘩的一种有效治疗方法；然而，在接下来的1年中需要观察患者是否复发。
