Ehsani Ala, Lotfi Fatemeh, Firooz Alireza, Ehsani Amirhoushang, Razavi Zahra, Ansari Mahshid Sadat, Nourmohammadpour Pedram, Sima Fatemeh, Koohian Mohammadabadi Mina, Rahimnia Amirhossein
Student Research Committee, Faculty of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran.
School of Medicine Iran University of Medical Sciences Tehran Iran.
Health Sci Rep. 2025 May 26;8(5):e70883. doi: 10.1002/hsr2.70883. eCollection 2025 May.
Keloids are challenging lesions to manage due to their resistance to treatment and high recurrence rates. This study evaluated the efficacy of an intralesional injection combining triamcinolone acetonide, 5-fluorouracil, and hyaluronidase compared with triamcinolone monotherapy in treating keloids.
This single-blinded clinical trial involved 16 participants, block-randomized into two groups. The intervention group received intralesional injections of triamcinolone acetonide (0.2 cc of 40 mg/cc solution), 5-fluorouracil (0.4 cc of 250 mg/5cc vial), and hyaluronidase (0.2 cc equivalent to 300 IU). The control group received triamcinolone acetonide (0.2 cc of 40 mg/cc solution) with 0.6 cc lidocaine of 2%. Keloid characteristics were assessed before treatment, after three injections at 3-4-week intervals, and 2 months posttreatment.
Significant improvements were observed in both groups. However, the intervention group showed greater reductions in lesion height, pliability, and modified Vancouver scar scale scores compared to the control group. No complications resulted from our interventional injection during the study period, while telangiectasia occurred with triamcinolone monotherapy.
These findings suggest that triple therapy was as effective as steroid monotherapy, with better outcomes in specific aspects of scar improvement and without side effects. Hyaluronidase could be promising for further research in this area.
瘢痕疙瘩因治疗抵抗和高复发率而成为具有挑战性的病变。本研究评估了曲安奈德、5-氟尿嘧啶和透明质酸酶联合病灶内注射与曲安奈德单一疗法治疗瘢痕疙瘩的疗效。
这项单盲临床试验纳入了16名参与者，通过区组随机化分为两组。干预组接受病灶内注射曲安奈德（0.2毫升40毫克/毫升溶液）、5-氟尿嘧啶（0.4毫升250毫克/5毫升小瓶）和透明质酸酶（0.2毫升相当于300国际单位）。对照组接受曲安奈德（0.2毫升40毫克/毫升溶液）与0.6毫升2%利多卡因。在治疗前、每隔3 - 4周注射三次后以及治疗后2个月评估瘢痕疙瘩特征。
两组均观察到显著改善。然而，与对照组相比，干预组在病变高度、柔韧性和改良温哥华瘢痕量表评分方面的降低幅度更大。在研究期间，我们的介入注射未导致并发症，而曲安奈德单一疗法出现了毛细血管扩张。
这些发现表明三联疗法与类固醇单一疗法效果相当，在瘢痕改善的特定方面有更好的结果且无副作用。透明质酸酶在该领域可能有进一步研究的前景。
