Comparison of Fractional CO2 Laser, Verapamil, and Triamcinolone for the Treatment of Keloid

被引:54
作者
Srivastava, Sunil [1 ]
Kumari, Hiranmayi [1 ]
Singh, Abhimanyu [1 ]
机构
[1] Rajasthan Univ Hlth Sci, Sawai Man Singh Med Coll & Hosp, Dept Plast Surg, 204 Anoop Villa,Surya Marg, Jaipur 302004, Rajasthan, India
关键词
keloid; CO2; laser; verapamil; triamcinolone; comparison; HYPERTROPHIC SCARS; INTRALESIONAL TRIAMCINOLONE; ACETONIDE;
D O I
10.1089/wound.2018.0798
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100227 [皮肤病学];
摘要
Objective: Scar biology is a territory less understood. The search for ideal treatment of keloid continues. The aim of this study was to compare the role of CO2 laser, triamcinolone (TAC), and verapamil in the treatment of keloid. Approach: A randomized parallel-group study was conducted in which 60 patients were randomly allocated to three groups from May 2017 to April 2018. First group received fractional CO2 laser therapy, second group received triamcinolone, and third group received intralesional verapamil. Outcomes were evaluated using Vancouver scar scale score at 3 weekly intervals for 6 months. Results: There was a reduction in scar height, vascularity, and pliability in all the three groups. However, pigmentation was not completely resolved by any of the three modalities. The response was fastest in case of triamcinolone followed by verapamil and laser, which was statistically significant. There was reduction in pain and pruritus in all the three groups and lesser injection site pain with verapamil. There was some amount of charring with CO2 laser. Innovation: Our study provides evidence that TAC has the fastest response in treating keloids when compared to other modalities. Scar pigmentation is the parameter that is not completely resolved by TAC, verapamil, or CO2 laser. Conclusion: The study revealed that fractional CO2 laser and verapamil are as efficient as triamcinolone acetonide (TAC) for treating keloids, except it takes longer for laser and verapamil to act compared to TAC. Verapamil can be used as an alternative treatment modality that is cost-effective with minimal adverse effects.
引用
收藏
页码:7 / 13
页数:7
相关论文
共 26 条
[1]
Addison T, 1854, Med Chir Trans, V37, P27
[2]
Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids [J].
Ahuja, Rajeev B. ;
Chatterjee, Pallab .
BURNS, 2014, 40 (04) :583-588
[3]
Scar Treatment with Lasers: A Review and Update [J].
Ru’aa Al Harithy ;
Kucy Pon .
Current Dermatology Reports, 2012, 1 (2) :69-75
[4]
Laser Treatment of Traumatic Scars With an Emphasis on Ablative Fractional Laser Resurfacing Consensus Report [J].
Anderson, R. Rox ;
Donelan, Matthias B. ;
Hivnor, Chad ;
Greeson, Eric ;
Ross, E. Victor ;
Shumaker, Peter R. ;
Uebelhoer, Nathan S. ;
Waibel, Jill S. .
JAMA DERMATOLOGY, 2014, 150 (02) :187-193
[5]
[Anonymous], J AM COLL CLIN WOUND
[6]
Keloids and Hypertrophic Scars: Pathophysiology, Classification, and Treatment [J].
Berman, Brian ;
Maderal, Andrea ;
Raphael, Brian .
DERMATOLOGIC SURGERY, 2017, 43 :S3-S18
[7]
Topical Verapamil as a Scar Modulator [J].
Boggio, Ricardo Frota ;
Boggio, Leonardo Frota ;
Galvao, Bruno Luiz ;
Machado-Santelli, Glaucia Maria .
AESTHETIC PLASTIC SURGERY, 2014, 38 (05) :968-975
[8]
Burn Scar Assessment: A Systematic Review of Different Scar Scales [J].
Brusselaers, Nele ;
Pirayesh, Ali ;
Hoeksema, Henk ;
Verbelen, Jozef ;
Blot, Stijn ;
Monstrey, Stan .
JOURNAL OF SURGICAL RESEARCH, 2010, 164 (01) :E115-E123
[9]
Verapamil is Less Effective than Triamcinolone for Prevention of Keloid Scar Recurrence After Excision in a Randomized Controlled Trial [J].
Danielsen, Patricia L. ;
Rea, Suzanne M. ;
Wood, Fiona M. ;
Fear, Mark W. ;
Viola, Helena M. ;
Hool, Livia C. ;
Gankande, Thilanee U. ;
Alghamdi, Mansour ;
Stevenson, Andrew W. ;
Manzur, Mitali ;
Wallace, Hilary J. .
ACTA DERMATO-VENEREOLOGICA, 2016, 96 (06) :774-778
[10]
Management of keloids and hypertrophic scars: current and emerging options [J].
Gauglitz, Gerd G. .
CLINICAL COSMETIC AND INVESTIGATIONAL DERMATOLOGY, 2013, 6 :103-114