A Comparative Clinical Study on Role of 5-Flurouracil Versus Triamcinolone in the Treatment of Keloids

Abstract

A wide range of therapies exist for keloids. But despite the multiple treatment modalities available, keloids still remain a significant challenge for both the clinician and the patient. To compare the efficacy of 5-flurouracil (5-FU) versus triamcinolone as a therapeutic agent for the treatment of keloids. A randomized control trial was carried out at a teaching hospital in Kolkata over a period 2.5 years. Fortyfour patients took part in the study, 20 in group F and 24 in group T. The age ranged from 16 to 66 years. The mean age of group F was 34.7±11.0124 years (range 16-66 years) and of group T was 32.96±9.584 years (range 19-60 years). The difference in the age and sex between the two groups was comparable and not statistically significant (p00.096). The response was rated as excellent (76-100% decrease in volume), good (51-75%), fair (26-50%), and poor (less than 25%). The reduction in keloid volume was comparable in both the groups. But side effects were much more in group F compared to group T. About 95% of the patients in group F found the injection very painful. About 6% of the patients in group F presented soon after the first two to three sessions with superficial ulcerations at the injection site accompanied by mild discomfort and discharge. This side effect was not seen in group T. Regarding pain at the injection site and superficial ulceration, the difference between the two groups was found to be statistically significant (p<0.05). The patients treated with 5-FU experienced side effects such as hyperpigmentation, pain at the injection site, and superficial ulceration, which were statistically highly significant. It appears from this study that triamcinolone is a better tolerated and less toxic alternative to 5-FU in the management of keloids.

Aesthetic correction of lesion by post-liposuction corticoid infiltration using subcision, PMMA filling, and CO2 laser

“…In this case, the treatment of fibrosis and its adhesions, tissue atrophy, and colour homogenisation had the objective of correcting the aesthetic damage, correction which was sought with the treatments applied to the patient. The use of injectable intralesional corticosteroids may cause some deformities in the skin [8], as presented in this case.…”

“…Injectable corticosteroid, used to inhibit the production of collagen, is known to act by inhibiting alpha-2 macroglobulin. This inhibits the action of collagenase type V, which promotes a decrease in the action of fibroblasts, thus, controlling the scar process [8].…”

“…Nevertheless, the physician carrying out the treatment should be aware of the possible side effects related to different prescribed forms and doses [7]. Some complications are due to intralesional injection, such as the development of telangiectasias, cutaneous atrophy, and hypo-or hyperpigmentation of the skin [8].…”

5-Fluorouracil in the Treatment of Keloids and Hypertrophic Scars: A Comprehensive Review of the Literature

“…Thirty-five percent of patients experienced reoccurrence of lesions at 6 months post-treatment. Both treatment regimens were equally effective in reducing keloid volume, but the side effects were noticeably worse in the 5-FU group, with 95% experiencing extreme pain and 65% experiencing superficial ulcerations [ 22 ].…”

Debulking of Keloid Combined with Intralesional Injection of 5-Flurouracil and Triamcinolone versus Intralesional Injection of 5-Flurouracil and Triamcinolone

“…This has been proven in a recent study done in vitro on keloid fibroblast. Triamcinolone acetonide has been shown to decrease both cellular proliferation and collagen production by dermal fibroblasts [14] [19]. Five flurouracil (5-FU) alone is effective in the treatment of keloids, and there is enough evidence that a combination of 5-FU and triamcinolone is superior over triamcinolone alone.…”