ABSTRACT
Author present a case of 22-year-old female with keloid due to previous trauma three years prior. Keloids are excessive fibroblast growth present in pathological scars. Therapy for keloids still remain a challenge requiring an effective intervention. While the first line has always been the use of intralesional triamcinolone, recently intralesional verapamil has also been known to reduce growth of keloids. Aim of the study was to evaluate the efficacy of both of these drug options. Literature searching was performed from three databases namely PubMed, Cochrane library and Science Direct. Findings were systematically narrowed down through inclusion and exclusion criteria into four relevant randomized controlled trials. Selected studies were critically appraised for its validity, importance, and applicability using tools from Oxford Center of Evidence-Based Medicine. Both intralesional triamcinolone and verapamil show their own benefit and risk. Triamcinolone is more effective in reducing keloid with faster improvement as seen in scar height reduction, vascularity, pigmentation and pliability. However, verapamil has fewer side effects which serve as a safer treatment option. More clinical trials in the future may be needed to obtain more conclusive result.
ABSTRACT
Intoduction:There are multiple treatment modalities for keloids but no single modality has been proven to be thegold standard. This study aims to compare the efficacy of intralesional triamcinolone acetonide (TAC)with silicone gel sheeting (SGS) in treating keloids and their effect on patients’ quality of life(QoL).Methods:This was a two-arm randomized-controlled trial involving 56 subjects in which intralesional TAC 20mg/mL after dilution with 2% lignocaine was administered on keloids monthly for patients in group1 while patients in group 2 applied SGS on keloids daily. Patients were treated for 12 weeks andfollowed-up for 16 weeks. Patient and Observer Scar Assessment Scale (POSAS) and DermatologyLife Quality Index (DLQI) were assessed to monitor treatment efficacy and patients’ QoL respectively.Results:There was 44.2% of improvement in the mean of total score of POSAS in group 1 as compared to11.6% in group 2 (p<0.001). Both groups showed significant improvement in vascularity, pigmentation,thickness and pliability but the improvement was more significant in group 1. Subjects in group 1demonstrated a 67.3% of DLQI score improvement as compared to 13.1% in group 2 (p<0.001). Sideeffects reported were pain during procedure in group 1 and pruritus in group 2.Conclusion:Intralesional TAC was superior than SGS in treating keloids as well as improving patients’ QoL andhence recommended as the first-line treatment. SGS can be considered as an alternative treatment forpatients who are intolerable to pain or as an adjunctive treatment.
ABSTRACT
Granuloma faciale (GF) is a chronic inflammatory disease of unknown origin characterized by nodular or granulomatous lesions on the face in adults. It is now regarded as a variant of vasculitis in which eosinophils are particularly numerous. It remains a benign, though chronic condition, not associated with systemic lesions like other forms of vasculitis. We report a case of 24-year-old male who presented with multiple erythematous nodules on photoexposed areas since past 2 years. The patient had been previously treated for Hansen’s disease for 3 months but with no relief. The patient responded wonderfully to intralesional triamcinolone and topical tacrolimus after two initial failed attempts with intralesional cryotherapy.
ABSTRACT
PURPOSE: To evaluate the effectiveness of intralesional triamcinolone acetonide injection, and incision and curettage for primary chalazia. METHODS: In order to compare the effectiveness of treatment modality, 103 patients who were diagnosed with primary chalazia were divided into 2 groups. The patients in group A underwent intralesional triamcinolone acetonide injection and the patients in group B underwent incision and curettage. The patients were followed up 1 week and 3 weeks after the procedures to identify the regression of the lesion and the procedure complications. A decision regarding success or failure was made at 3 and 6 weeks after the treatment. Successful treatment was defined as the infallibility in the functional and esthetic aspects as well as the size of regressed lesion. RESULTS: This study included 82 out of 103 patients, who satisfied the inclusion criteria. Forty-four patients underwent intralesional triamcinolone acetonide injection and the remaining 38 patients underwent incision and curettage. The success rate of the initial treatment, which was identified 3 weeks after the procedure, was 81.8% in group A and 86.8% in group B. The cumulative success rate of treatment after 6 weeks was 86.8% in group A and 92.1% in group B. No complications were observed with both treatment modalities. CONCLUSIONS: Intralesional triamcinolone acetonide injection is as effective and safe as incision and curettage for the treatment of primary chalazia.