Efficacy of Intralesion Injection of Combined 5-Flourouracil and Triamcinolone versus Triamcinalone alone in Keloids and Hypertrophic Scars: A Comparative Analysis

Abstract

Objective: The treatment of keloids and hypertrophic scars is challenging and controversial. The therapeutic agents found in the literature include silicone sheets, compression garments, corticosteroid injections, 5-fluorouracil (5-FU), bleomycin and interferon, topical imiquimod, cryotherapy, radiation, and laser or light-based therapies. Triamcinolone acetonide (TCA), a corticosteroid, considered first line treatment for the prevention and treatment of keloids and hypertrophic scars. To compare the efficacy of triamcinolone acetonide alone and triamcinolone acetonide plus 5-florouracil for treating keloids and hypertrophic scars in burn patients.

Methodology: In this study, the patients were divided into two groups A and B on the basis of treatment regimen, i.e. Group A (TCA alone) and Group B (5FU+TCA). The efficacy of both treatments was compared for improvement in Vancouver scar scale (VSS) and pruritus scale.

Results: The mean VSS score pretreatment was calculated as 10.74±2.36 in Group A and 10.27±3.14 in Group B.  Post-treatment, it was reduced to 5.58±1.04 in Group-A and 3.41±2.11 in Group-B. The comparison of efficacy shows an improvement of 65.80% in Group A and 75.07% in Group B; the p value was 0.047, showing a significant difference.

Conclusion: Combination therapy of intra-lesion injection of triamcinolone acetonide and 5-florouracil has significantly higher efficacy as compared to triamcinolone acetonide alone for the treatment of keloids and hypertrophic scars, but necessary precautions have to be taken.