Assesment of the treatment of earlobe keloids with triamcinolone injections, surgical resection, and local pressure

Carvalhaes, Silvia Mandello; Petroianu, Andy; Ferreira, Mauro A. T.; Barros, Virgínea Magalhães de; Lopes, Raquel Virgínea

doi:10.1590/0100-69912015001003

Cited by 20 publications

(23 citation statements)

References 21 publications

(15 reference statements)

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“…Hypertrophic scar (HS) is a very common cutaneous complication following dermal wound, especially after severe burns78. Currently, there are a variety of therapeutic options for treatment of HS including pressure therapy (PT), silicone-based products, intralesional corticosteroids, laser therapy, bleomycin, fluorouracil, topical imiquimod and surgical excision2910. However, no ideal or all-purpose method of scar control exists and HS management remains a problematic challenge for both patients and health care providers511.…”

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confidence: 99%

“…Secondly, the effectiveness of PT in HS prevention and treatment remains controversial. Some studies showed that PT could promote HS maturation, restrain its formation, improve its appearance, minimize itch and pain1020. However, others indicated that PT not only left the ultimate outcome of burn wounds unchanged but also increased the incidence of overheating, pruritus, blistering, wound breakdown and abnormal bone growth718.…”

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confidence: 99%

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The effectiveness of pressure therapy (15–25 mmHg) for hypertrophic burn scars: A systematic review and meta-analysis

Liu

Pei

et al. 2017

Sci Rep

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Although pressure therapy (PT) represents the standard care for prevention and treatment of hypertrophic scar (HS) from burns, its practice is largely based on empirical evidence and its effectiveness remains controversial. To clarify the effect of PT (15–25 mmHg) for HS, we performed the systematic review and meta-analysis. Several electronic databases were screened to identify related randomized controlled trials (RCTs). 12 RCTs involving 710 patients with 761 HS resulting from burn injuries were included. Compared with non/low-PT, cases treated with PT (15–25 mmHg) showed significant differences in Vancouver Scar Scale score (MD = −0.58, 95% CI = −0.78–−0.37), thickness (SMD = −0.25, 95% CI = −0.40–−0.11), brightness (MD = 2.00, 95% CI = 0.59–3.42), redness (MD = −0.79, 95% CI = −1.52–−0.07), pigmentation (MD = −0.16, 95% CI = −0.32–−0.00) and hardness (SMD = −0.65, 95% CI = −1.07–−0.23). However, there was no difference in vascularity (MD = 0.03, 95% CI = −0.43–0.48). Our analysis indicated that patients with HS who were managed with PT (15–25 mmHg) showed significant improvements. Due to limitations, more large and well-designed studies are needed to confirm our findings and the side-effects of the PT may also need to be evaluated.

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confidence: 99%

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confidence: 99%

The effectiveness of pressure therapy (15–25 mmHg) for hypertrophic burn scars: A systematic review and meta-analysis

Liu

Pei

et al. 2017

Sci Rep

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“…20mg/ml reduces the side effects of TAC without jeopardizing the efficacy. [16][17][18] In this study, majority of the subjects were in the age group <30 years; males being slightly more than females. Uzair et al and Ahuja et al also observed predominance of keloid in the younger age group.…”

Section: Resultsmentioning

confidence: 67%

The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

Garg

Shah

Garg³

et al. 2018

Int Surg J

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Background: Management of keloid is difficult as well as challenging. Intralesional triamcinolone acetonide (TAC) injections have remained a gold standard in non-surgical management of keloid. TAC is generally used in the concentration of 40mg/ml, which causes adverse effects such as local dermal atrophy and hypopigmentation. Aim was to study efficacy and adverse effects of TAC in treatment of keloid, in a lesser concentration of 20mg/ml.Methods: An open label study was conducted from November 2015 to May 2017 on 25 subjects of either gender, in the age group 11-55 years, at a medical college hospital. Intralesional injection TAC 20 was administered in the keloid at an interval of 3 weeks, for a total of 6 sessions, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement and SPSS 21 for statistical analysis.Results: Mean age of keloid subjects was 30.72 years and median duration of keloid was 8 months. The mean VSS score before treatment was 8.36 which reduced to 3.20 after treatment. Mean percentage change in VSS score was 62.79%, which was very highly significant (p <0.001). Physician’s assessment was ‘Very Good’ in 52.0% and ‘Excellent’ in 5 (20%). Adverse effect of atrophy was seen in 3 (12%), hypopigmentation in 11 (44%) and telangiectasia in 4 (16%).Conclusions: Intralesional injection triamcinolone acetonide 20mg/ml gives very good to excellent improvement in the majority of patients of keloid. Local adverse effects seen were hypopigmentation, atrophy and telengiectasia.

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“…[7] However, anaphylactic reactions have been observed due to triamcinolone injections. [8] Adjuvant radiotherapy resulted in one study to a reduced recurrence rate of 4%. [9] Short-term adverse effects were not observed.…”

Section: Discussionmentioning

confidence: 99%

Giant relapsing earlobe keloid – Successful combined treatment by surgery and pressure earring

Goldman¹,

Wollina²

2017

IJMDCR

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Keloids of the earlobe are frequent. The effective treatment remains a challenge. Intralesional injections, topical corticosteroids, cryotherapy, radiotherapy, laser therapy, and pressure dressings represent some treatment options. To demonstrate the effectiveness of positive pressure dressings after surgical excision to prevent recurrence of earlobe keloid. 2 weeks after surgical excision, the patient was instructed to wear pressure earrings. The dressing was worn for at least 12 h a day during 6 months. The patient was followed 3 years after the surgery. There was no recurrence of the earlobe keloid. Pressure earring was effective for prevention of relapsing keloid scar after surgical removal.

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Assesment of the treatment of earlobe keloids with triamcinolone injections, surgical resection, and local pressure

Abstract: the combination of infiltration TCN month to 20 mg/mL (1.2mg to 2.0mg per mm3 TCN injury), surgical excision and pressure application device is effective for treatment of keloid ear lobe.

Cited by 20 publications

References 21 publications

The effectiveness of pressure therapy (15–25 mmHg) for hypertrophic burn scars: A systematic review and meta-analysis

The effectiveness of pressure therapy (15–25 mmHg) for hypertrophic burn scars: A systematic review and meta-analysis

The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

Giant relapsing earlobe keloid – Successful combined treatment by surgery and pressure earring

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