Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Scar Laser and Plastic Surgery Center, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, Korea.
Dermatol Surg. 2019 Jun;45(6):802-810. doi: 10.1097/DSS.0000000000001695.
Recent advances in keloid management favor the administration of combination therapy over monotherapy.
The authors evaluated the safety and efficacy of combination therapy to treat keloids using fractional lasers, cryotherapy, and intralesional corticosteroids.
The authors performed a retrospective study involving 35 Korean patients. Each patient underwent treatment using the 1,550 nm nonablative fractional erbium-glass laser, followed by the 10,600 nm ablative fractional carbon dioxide laser. Laser treatment was immediately followed by the administration of superficial cryotherapy and intralesional triamcinolone injection. Therapeutic efficacy was assessed using the Vancouver Scar Scale (VSS) score and the 7-point patient self-assessment score.
The mean total and subcategory VSS scores showed statistically significant improvements. The height and pliability scores showed the most significant and quickest responses to the combination therapy. The patients reported remarkable improvement in itching, pain, and limitations of motion after a single combination therapy session. Twenty patients were followed up for 1 year after the discontinuation of the combination treatment, and the recurrence was observed only in one patient. No significant adverse effects were observed throughout the follow-up period.
Combination keloid therapy using fractional lasers, superficial cryotherapy, and intralesional triamcinolone injection is safe and more effective than individual monotherapies.
近年来，瘢痕疙瘩的治疗方法倾向于联合治疗而非单一疗法。
作者评估了使用分束激光、冷冻疗法和皮质内固醇注射的联合疗法治疗瘢痕疙瘩的安全性和有效性。
作者进行了一项回顾性研究，涉及 35 名韩国患者。每位患者均接受 1550nm 非剥脱性铒玻璃激光和 10600nm 剥脱性二氧化碳激光治疗。激光治疗后立即进行浅表冷冻疗法和皮质内曲安奈德注射。使用温哥华瘢痕量表（VSS）评分和 7 分患者自我评估评分评估治疗效果。
总 VSS 评分和各分项 VSS 评分均有显著改善。高度和柔韧性评分对联合治疗的反应最为显著和迅速。患者在单次联合治疗后报告瘙痒、疼痛和运动受限明显改善。20 例患者在联合治疗停止后随访 1 年，仅 1 例复发。整个随访期间未观察到明显的不良反应。
使用分束激光、浅表冷冻疗法和皮质内曲安奈德注射的联合瘢痕疙瘩治疗比单一疗法更安全、更有效。
