Comparing the Effect of Intralesional 5-Fluorouracil (5-FU) Alone Versus Intralesional 5-FU Combined With Triamcinolone Acetonide for Keloid Treatment.

INTRODUCTION

Keloid is a benign hyper-proliferative growth of dermal fibroblasts, which extends beyond the borders of the original wound. It does not regress spontaneously and has the tendency to recur after excision.

OBJECTIVES

To compare the efficacy of intralesional 5-fluorouracil (5-FU) alone versus intralesional 5-FU combined with triamcinolone acetonide (TCA) in the treatment of keloids.

METHODOLOGY

This prospective observational study was conducted at the Department of Dermatology, Sheikh Zayed Hospital, Lahore, Pakistan, from July 2018 to July 2019. In this study, 66 cases, 33 in each group of aged 15-50 years having keloid of at least three or more on the Vancouver scar scale (VSS) score lasting less than five years, were included. The 66 patients were categorized into two equal groups. Group A was treated with 5-FU alone, and group B with 5-FU combined with TCA. Efficacy was defined as achieving a VSS score of 0 after eight weeks of treatment.

RESULTS

From the 66 patients, there were 19 (57.58%) males in group A and 15 (46.88%) in group B. There were a total of nine (27.27%) cases of diabetes mellitus (DM) in group A and eight (24.24%) in group B. There were 12 (36.36%) and 10 (30.30%) hypertensive cases in groups A and B, respectively. Compliance was 100% in both groups. Efficacy in group A was seen in 25 (75.76%) cases and 32 (96.97%) cases in group B, with a p-value of 0.02. This efficacy was significantly better in group B in terms of male gender, where it was seen in 100% of cases in group B compared to 13 (68.42%) of cases in group A, with a p-value of 0.02. There was no significant difference in terms of age groups, BMI, and hypertension (HTN). The efficacy in diabetics was nearly significantly better in group B, where it was seen in 100% of the cases (p = 0.08).

CONCLUSION

Both groups are efficacious for the treatment of keloid; however, the combination of 5-FU and TCA revealed greater efficacy, and it was significantly better than 5-FU alone. The results were again significantly better in terms of efficacy in the male gender and those who had keloids for more than one year.