Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
J Dermatolog Treat. 2022 Feb;33(1):150-156. doi: 10.1080/09546634.2020.1730742. Epub 2020 Mar 4.
Keloids are benign fibro-proliferative growths occurring after skin injury or spontaneously. Intralesional triamcinolone acetonide (TA) is their first-line therapy, but commonly associated with side effects or recurrence. Platelet rich plasma (PRP) is an autologous blood-derived product with promising results in improving wound healing with lower keloid occurrence.
To compare the efficacy of combined intralesional TA and PRP versus TA alone in keloids treatment.
Forty patients with keloids were divided randomly into two equal groups (A and B). Both groups received intralesional TA (20 mg/ml) for four sessions, 3 weeks apart. Group A patients received additional intralesional PRP 1 week after TA injections. Evaluation was done after 3 months of follow up by Vancouver scar scale (VSS) and verbal rating scale (VRS) for pain and itching.
Both groups showed significant improvement in all parameters of VSS and VRS in comparison with baseline. Significantly better improvement in height, pigmentation, and pliability and overall VSS was detected in patients of group A. A significantly higher incidence of post-TA atrophy and hypopigmentation was observed in group B.
Combining intralesional PRP with TA could yield cosmetically better outcomes in keloid treatment with lower incidence of TA-induced side effects especially atrophy and hypopigmentation.
瘢痕疙瘩是皮肤损伤或自发后出现的良性纤维增生性生长。病灶内曲安奈德（TA）是其一线治疗方法，但常伴有副作用或复发。富血小板血浆（PRP）是一种自体血液衍生产品，在改善伤口愈合方面具有良好的效果，瘢痕疙瘩的发生率较低。
比较病灶内 TA 联合 PRP 与单独 TA 治疗瘢痕疙瘩的疗效。
将 40 例瘢痕疙瘩患者随机分为两组（A 组和 B 组），每组 20 例。两组均接受病灶内 TA（20mg/ml）治疗，每 3 周 1 次，共 4 次。A 组患者在 TA 注射后 1 周内接受额外的病灶内 PRP 治疗。在随访 3 个月后，采用温哥华瘢痕量表（VSS）和疼痛及瘙痒的口头评分量表（VRS）进行评估。
与基线相比，两组在 VSS 和 VRS 的所有参数上均有显著改善。A 组患者在高度、色素沉着、柔韧性和整体 VSS 方面的改善明显更好。B 组患者 TA 后萎缩和色素减退的发生率明显更高。
病灶内 PRP 联合 TA 治疗瘢痕疙瘩可获得更好的美容效果，且 TA 诱导的副作用（尤其是萎缩和色素减退）发生率较低。
