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Treating keloids with injections

Presented By
David M. Ozog, Henry Ford Hospital, USA
WCD 2019

Injecting keloids is one of the common treatment approaches. Outcomes and relapse rates are best if different agents are combined [1].

Three main injectable drug classes are often used in the treatment of keloids and hypertrophic scars: corticosteroids (CS), antimetabolites (e.g. 5-fluorouracil [5-FU]), and anti-tumour agents (e.g. bleomycin) [1,2]. Among other things, steroids suppress the inflammatory process, reduce the synthesis of collagen and glycosaminoglycans, and inhibit fibroblast growth [3].

The most commonly used CS is triamcinolone acetonide (TAC) in a dose of 10-40 mg/mL; but different treatment intervals are reported on in literature [3]. Used as monotherapy, CS are primarily efficacious in 50%-100% but show a substantial recurrence rate of 9%-50% [3]. In a comparison between TAC injections and 5-FU injections over 6 months, no statistical significance was found, but 5-FU had fewer local adverse events such as skin atrophy (TAC 44% vs...

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