Behera Biswanath, Kumari Rashmi, Thappa Devinder Mohan, Malathi Munisamy
Department of Dermatology, Venereology, and Leprology, JIPMER, Puducherry, India.
Dermatol Surg. 2016 Oct;42(10):1188-98. doi: 10.1097/DSS.0000000000000873.
Keloids are difficult to treat due to their poor response and high recurrence rate.
We conducted a randomized controlled trial to compare the therapeutic efficacy of intralesional triamcinolone acetonide (ILTA) in combination with carbon dioxide laser (Group 1) versus in combination with cryotherapy (Group 2) in the treatment of keloids.
Sixty patients with 101 keloids were randomized into 2 groups. On Day 1, keloids were ablated using either CO2 laser or cryotherapy followed by injection of ILTA at baseline and at 4 weeks interval for 3 months. Patients were followed up for 12 months to assess for therapeutic response and side effects.
Successful therapeutic response (>50% improvement) between the 2 groups (CO2 vs cryotherapy) were assessed in terms of reduction in thickness, reduction in volume, patient's self-assessment, observer's assessment, and Vancouver Scar Scale score at the end of 6 months and 12 months (55.55% vs 70.37%; 61.1% vs 77.8%; 75% vs 77.78%; 61.12% vs 85.18%; 52.78% vs 62.96% respectively). The difference in therapeutic response between the 2 groups was not statistically significant at the end of 12 months.
Both CO2 laser and cryotherapy in combination with ILTA were found to be equally effective in the treatment of keloids.
瘢痕疙瘩因其反应不佳和高复发率而难以治疗。
我们进行了一项随机对照试验,比较曲安奈德皮损内注射(ILTA)联合二氧化碳激光(第1组)与联合冷冻疗法(第2组)治疗瘢痕疙瘩的疗效。
将60例有101个瘢痕疙瘩的患者随机分为2组。第1天,使用二氧化碳激光或冷冻疗法切除瘢痕疙瘩,随后在基线时以及每隔4周注射ILTA,持续3个月。对患者进行12个月的随访,以评估治疗反应和副作用。
根据6个月和12个月结束时瘢痕疙瘩厚度的减少、体积的减少、患者的自我评估、观察者的评估以及温哥华瘢痕量表评分,评估两组(二氧化碳激光组与冷冻疗法组)之间的成功治疗反应(改善>50%)(分别为55.55%对70.37%;61.1%对77.8%;75%对77.78%;61.12%对85.18%;52.78%对62.96%)。12个月结束时,两组之间的治疗反应差异无统计学意义。
发现二氧化碳激光和冷冻疗法联合ILTA在治疗瘢痕疙瘩方面同样有效。