A study of verapamil in treatment of keloid

Abstract

<p class="abstract"><strong>Background:</strong> Keloid is a common presentation in clinical practice. Symptoms due to keloid are mild, but disfigurement and functional impairment can be severe. It is difficult to treat. Intralesional, injection triamcinolone acetonide, has limited efficacy, causes adverse effects such as local dermal atrophy, telengiectasia and hypopigmentation. Injection verapamil is reported to have similar efficacy, but lesser side effects, and is cheaper. Aim was to study efficacy and adverse effects of intralesional verapamil in treatment of keloid.</p><p class="abstract"><strong>Methods:</strong> An open label study on 25 patients of keloid, either gender, age 11 to 55 years at a medical college hospital. Injection verapamil 2.5 mg/ml was administered intralesionally, at an interval of 3 weeks, for a total of 6 sittings, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement. The statistical analysis was done using SPSS version 21.0.<strong></strong></p><p class="abstract"><strong>Results:</strong> Median duration of keloids was 8 months. The mean VSS score before treatment was 7.68 which reduced to 4.28 after treatment. Mean percentage change in VSS score was 46.21%, very highly significant (p<0.001). Physician’s assessment was ‘very good’ in 32.0% and 'excellent' in 8.0%. The complaint of post-procedure pain was present in almost all.</p><p class="abstract"><strong>Conclusions:</strong> Intralesional injection verapamil, gives very good to excellent improvement in 40% of patients of keloid. Post injection pain persists for more than 24 hours. Drug does not cause local dermal atrophy or hypopigmentation.</p>

Intralesional verapamil in the treatment of keloids: A clinical, histopathological, and immunohistochemical study

“…In our study, the most common side effect was pain at the site of injection as it was reported in 36 keloids (83.7%), this finding was in agreement with that of previous studies 17,20,21 …”

“…19 Another study demonstrated that In our study, the most common side effect was pain at the site of injection as it was reported in 36 keloids (83.7%), this finding was in agreement with that of previous studies. 17,20,21 In our study, recurrence was observed in 9 keloids (20.9%), which was in agreement with the results obtained by a previous study com-…”

“…Clinical outcome was very good to excellent in 40%, good in 44%, and poor response in only 16% of the cases. None of the patients showed hypopigmentation 17 …”

“…None of the patients showed hypopigmentation. 17 Moreover, other studies demonstrated the efficacy and safety of IL verapamil in the treatment of keloids. 18,19 A previous study found that excision of keloids followed by pressure dressings and IL verapamil resulted in 55% reduction in height of keloid at a follow-up interval of 28 months.…”

Evaluating the efficacy of intralesional verapamil over intralesional triamcinolone in management of keloid: an evidence based case report

“…28,29 An open label study found that there is a significant decrease in VSS score after administration of intralesional verapamil within 8 months (p<0.001) with no complaint of post-procedural pain experienced. 30 However, reasons why verapamil remain as second-line treatment in keloid management needs to be further discussed.…”