The clinical efficacy of single-hole punch excision combined with intralesional steroid injection for nodular keloid treatment: a self-controlled trial

There are many methods to treat keloid, including various excision operations, laser, injection and radiotherapy. However, few studies have explored the effectiveness of single-hole punch excision in keloid treatment. This study aimed to investigate the efficacy and safety of lateral punch excision...

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Bibliographic Details
Published in:	Scientific reports Vol. 14; no. 1; p. 9793
Main Authors:	Liu, Bingbing, Lin, Haoying, Zhang, Minghai
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 29-04-2024 Nature Publishing Group Nature Portfolio
Subjects:	692/308 692/699 Adolescent Adult Combined Modality Therapy Female Humanities and Social Sciences Humans Injection Injections, Intralesional - methods Intralesional injection Keloid - drug therapy Keloid - surgery Keloid - therapy Lesions Male Middle Aged multidisciplinary Nodular keloid Punch excision Radiation therapy Science Science (multidisciplinary) Side effects Single-hole Skin diseases Skin lesions Statistical analysis Steroid Steroids Steroids - administration & dosage Symmetry Treatment Outcome Young Adult Nodular keloid Steroid Recurrence Intralesional injection Punch excision Single-hole Symmetry
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Summary:	There are many methods to treat keloid, including various excision operations, laser, injection and radiotherapy. However, few studies have explored the effectiveness of single-hole punch excision in keloid treatment. This study aimed to investigate the efficacy and safety of lateral punch excision combined with intralesional steroid injection for keloid treatment through self-control trial. In this self-controlled trial, 50 patients meet the diagnosis of nodular keloid, and try to choose left–right symmetrical control, one skin lesion in the control group (50 skin lesionsin total) and the other in the observation group (50 skin lesions in total).The keloids in the treatment group were initially treated with punch excision combined with intralesional steroid injection, followed by injection treatment alone. Keloids in the control group received intralesional steroid injection alone. The Vancouver Scar Scale (VSS) of the keloid before and after the punch excision was evaluated; the keloid scores at different time points and the number of injection treatments required in both groups were compared, and adverse reactions were observed. The effective rate of the observation group was 86.0%, which was significantly higher than that of the control group (66.0%), and the recurrence rate of 22% was lower than that of the control group (χ 2 = 4.141,63417), all of which were statistically significant (all P < 0.05). At the end of treatment, the VSS and total injection times in the observation group were significantly lower than those in the control group (t = 5.900,3.361), with statistical significance ( P < 0.01). The combination of single-hole punch excision and intralesional steroid injection is an effective method to treat multiple nodular keloids, shortening the treatment course of tralesional steroid injection without obvious adverse reactions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-024-60670-x