Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids

Shanthi, F X Margaret; Ernest, K; Dhanraj, Prema

doi:10.4103/0378-6323.42899

Cited by 80 publications

(67 citation statements)

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“…A single-blind, parallel-group study demonstrated that intralesional verapamil was comparable to intralesional triamcinolone acetonide in the treatment of keloids. Both were found to produce similar results (i.e., reductions of scar vascularity, pliability, height, and width) [60]. Intralesional triamcinolone achieved these effects faster but also had a greater incidence of adverse reactions than intralesional verapamil did [60].…”

Section: Methodsmentioning

confidence: 99%

Recent Developments in the Use of Intralesional Injections Keloid Treatment

Perdanasari

Lazzeri

et al. 2014

Arch Plast Surg

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Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.

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Section: Methodsmentioning

confidence: 99%

Recent Developments in the Use of Intralesional Injections Keloid Treatment

Perdanasari

Lazzeri

et al. 2014

Arch Plast Surg

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“…Allocation concealment was not reported in all of the eight studies (11, 16, 20–25), and we judged all trials as unclear for allocation concealment. Two single-blinded trials (16, 24) were judged as high risk for blinding of participants and personnel. Complete information on the blinding processes was not shown by the left six studies (11, 20–23, 25) and we judged them at unclear risk for performance bias.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies (16, 25) employed blinded observer to assess outcomes and were judged at low risk of detection bias. The left six trials (11, 20–24) were judged as unclear risk due to no report on blinding of outcome assessment. Four trials (11, 16, 20, 24) were judged at high risk for incomplete outcome data because the numbers lost to follow up were high and no reasons were given for the losses.…”

Section: Resultsmentioning

confidence: 99%

“…The left six trials (11, 20–24) were judged as unclear risk due to no report on blinding of outcome assessment. Four trials (11, 16, 20, 24) were judged at high risk for incomplete outcome data because the numbers lost to follow up were high and no reasons were given for the losses. No reporting bias or other bias was observed in all eight studies (11, 16, 20–25).…”

Section: Resultsmentioning

confidence: 99%

“…Two trials (24, 25) compared the use of TAC with verapamil. Forty patients (48 scars) were divided into TAC group (22 scars) and verapamil group (26 scars) in the study of Ahuja and Chatterjee (25).…”

Section: Resultsmentioning

confidence: 99%

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The Efficacy of Triamcinolone Acetonide in Keloid Treatment: A Systematic Review and Meta-analysis

Wong

Chen

et al. 2016

Front. Med.

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Keloid is a cutaneous dermal outgrowth resulting from uncontrolled deposition of collagen and glycosaminoglycan around the wound. The uncontrolled and persistent growth of keloids scar will result in cosmetic disfigurement, functional impairment, and affect the quality of life. Triamcinolone acetonide (TAC) is traditionally employed in treating keloid scars. In this study, we aim to evaluate the effectiveness of TAC and compare it with other common therapy employed in keloid treatment. Only randomized controlled trial (RCT) and controlled trial were included. Inverse variance risk ratio, weighted mean difference, and corresponding 95% confidence intervals were calculated to evaluate the effect of intervention. Meta-analysis indicated that TAC treatment significantly reduced the size of keloid compared to untreated control. Reduction in size was statistically different in favor of TAC compared to silicone gel sheet. Significant difference in favor of TAC was observed compared with verapamil in term of vascularity and scar pliability. TAC treatment was more effective in reducing scar thickness in comparison with cryotherapy. However, the current meta-analysis has several limitations. Only a limited number of trials with the same comparison are available. Most trials recruited a small number of patients and used inconsistent outcome assessment. Most trials did not provide detail information on allocation concealment and blinding. Therefore, further evaluation in multi-center RCTs with consistent comparisons and outcome measurements are warrant to reach a consensus on the selection between TAC and different treatment modalities.

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