The facial keloid: a comparison of treatment outcome between intralesional steroid injection and excision combined with radiotherapy

• Published in: European journal of plastic surgery Vol. 37; no. 7; pp. 361 - 366
• Main Authors: Aluko-Olokun, Bayo, Olaitan, Ademola Abayomi, Ladeinde, Akinola Ladipo, Oginni, Fadekemi Olufunmilayo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2014
• Subjects: Medicine; Medicine & Public Health; Original Paper; Plastic Surgery; Excision; Triamcinolone; Radiotherapy; Keloid; Intralesional
• ISSN: 0930-343X; 1435-0130
• DOI: 10.1007/s00238-014-0957-1

Background
Various conflicting claims of superiority of particular treatment modalities or regimens abound in the literature for the treatment of keloid. This study was designed to determine the more reliable method to flatten keloid between intralesional triamcinolone injection and excision combined with radiotherapy.
Methods
One hundred and seven consecutive patients presenting with facial keloids were alternately allocated into two groups. Group A was managed by intralesional injection of 10 mg per linear centimetre of keloid scar, fortnightly for a maximum of 6 months, while group B underwent excision combined with 16 Gray of radiation administered in four fractions, in as many consecutive days, commencing immediately preoperatively.
Results
Flattening of lesion was achieved in 81 % of scars managed with triamcinolone, while 58 % of those treated by excision combined with radiotherapy remained flat during the course of study. The difference between the two results was statistically significant (
P
 < 0.01).
Conclusions
Intralesional injection of triamcinolone is significantly more efficacious than excision combined with radiotherapy in the management of facial keloids.
Level of Evidence: Level II, therapeutic study.