Yasmin Magdy Abdulrahman Serag-Eldin1, Wael Hussein Mahmoud2, Mohamed Mahmoud Gamea3, Doaa Salah Hegab3. 1. Resident of Dermatology and Venereology, Dermatology and Venereology Department- Faculty of Medicine, Tanta University. 2. Assistant Professor of Plastic surgery. Plastic surgery Department- Faculty of Medicine, Tanta University. 3. Dermatology and Venereology, Dermatology and Venereology Department- Faculty of Medicine, Tanta University.
Abstract
BACKGROUND: Keloids are common fibroproliferative tumours and their treatment still represents a dilemma. Intralesional triamcinolone acetonide (TAC) injection is effective, but frequently associated with side effects. Pentoxifyllin (PTX) is a vasodilator, anti-inflammatory and anti-fibrotic agent. Its intralesional injection in keloids hasn't been evaluated yet. AIMS: Evaluating the efficacy and safety of intralesional PTX versus intralesional TAC and their combination for treatment of keloids. PATIENTS∕ METHODS: 30 patients with keloids were divided into three equal groups and treated by intralesional injection of TAC, PTX or their combination (admixed in 1:1 ratio). Injections were repeated every 3 weeks till lesional flattening or for maximum of 5 sessions. Evaluation was done by Vancouver Scar Scale and Verbal Rating Scale for pain and itching. RESULTS: Significant improvement in VSS was detected in all groups. Significantly better improvements in keloid height, pliability, pain and itching were detected in TAC and combination groups than PTX group. There was a significantly higher incidence of side effects (atrophy, hypopigmentation, telangiectasia and precipitations of TAC) in TAC group than combination group, while no side effects were reported in PTX group. A statistically significant less number of treatment sessions (required to achieve best results) was detected in patients of combination group. CONCLUSIONS: Intralesional injection of PTX is a potentially helpful, safe and well-tolerated therapeutic tool for keloids, but with lower efficacy than intralesional TAC when used solely. Combining PTX and TAC impairs significantly better results for keloid treatment and lowers the risk of TAC-induced side effects. This article is protected by copyright. All rights reserved.
BACKGROUND: Keloids are common fibroproliferative tumours and their treatment still represents a dilemma. Intralesional triamcinolone acetonide (TAC) injection is effective, but frequently associated with side effects. Pentoxifyllin (PTX) is a vasodilator, anti-inflammatory and anti-fibrotic agent. Its intralesional injection in keloids hasn't been evaluated yet. AIMS: Evaluating the efficacy and safety of intralesional PTX versus intralesional TAC and their combination for treatment of keloids. PATIENTS∕ METHODS: 30 patients with keloids were divided into three equal groups and treated by intralesional injection of TAC, PTX or their combination (admixed in 1:1 ratio). Injections were repeated every 3 weeks till lesional flattening or for maximum of 5 sessions. Evaluation was done by Vancouver Scar Scale and Verbal Rating Scale for pain and itching. RESULTS: Significant improvement in VSS was detected in all groups. Significantly better improvements in keloid height, pliability, pain and itching were detected in TAC and combination groups than PTX group. There was a significantly higher incidence of side effects (atrophy, hypopigmentation, telangiectasia and precipitations of TAC) in TAC group than combination group, while no side effects were reported in PTX group. A statistically significant less number of treatment sessions (required to achieve best results) was detected in patients of combination group. CONCLUSIONS: Intralesional injection of PTX is a potentially helpful, safe and well-tolerated therapeutic tool for keloids, but with lower efficacy than intralesional TAC when used solely. Combining PTX and TAC impairs significantly better results for keloid treatment and lowers the risk of TAC-induced side effects. This article is protected by copyright. All rights reserved.