Comparative Study of Combination of Intralesional Triamcinolone Acetate with 5-Fluorouracil Versus Triamcinolone Alone in Treatment of Keloid

Abstract

Objectives To assess various parameters of outcomes in the management of keloid by comparing the combination of 5-Fluorouracil (5-FU) with triamcinolone acetate and triamcinolone alone. Materials and Methods The present study was carried out as a prospective comparative study over a period of 24 months. A total of 70 diagnosed Keloids patients were included in the study, who were randomly divided into two equal groups: 35 patients were administered triamcinolone acetate and 5-FU (0.1 mL TA + 0.9 mL 5-FU) were classified as Group A (Triamcinolone acetonide [TAC] + 5-FU) while the remaining 35 (50.0%) patients were administered a 1 mL intralesional injection of triamcinolone acetate alone and were classified as Group B (TAC alone). Patients of both groups were administered the injections selected for them at a 3 week interval for 3–6 months. Patients and independent observers assessed the scar at each visit until the last follow-up. Assessment by patients was done for pain, itching, scar colour, stiffness, thickness and irregularity of the keloid on a 10-point scale, with higher values showing worse results. Assessment of scars by an independent observer was done on a similar scale, including vascularization, pigmentation, thickness and pliability. Results Initially vascularity, scar colour, vascularity and thickness of patients’ scars in both the groups assessed by the patient as well as the observer were comparable, which remained comparable up to the administration of the second dose. Thereafter, both patient and observer observed that the parameters of TAC + 5-FU administered patients were significantly lower than of those administered TAC alone. Assessment of irregularity in shape and pliability of scar was done only by the patient. Initially both irregularity and pliability of the patients in both groups were comparable, which remained comparable up to the administration of the third dose. Thereafter, the parameters of TAC + 5-FU administered patients were significantly lower than those administered TAC alone. Conclusion The findings in this study indicate that adjuvant 5-FU to TAC was more effective as compared to TAC alone.