Comparison of the Efficacy of Intralesional Triamcinolone Acetonide and Silicone Gel Sheeting for the Treatment of Keloids

ABSTRACT

IntoductionThere 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.