COMPARISON OF THE EFFICACY OF INTRALESIONAL 5% FU VERSUS INTRALESIONAL TRIAMCINOLONE IN PATIENTS PRESENTING WITH KELOID AND HYPERTROPHIC SCAR AT TERTIARY CARE HOSPITAL, KARACHI

B. Shah, R. Ghafoor, N. Asad, A. Samee, M. Surhiyo, A. Sattar
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Abstract

Despite the fact that keloids and hypertrophic scars are frequent benign hyper-proliferative growths of dermal fibroblasts, the clinical concerns, such as physical and psychological issues, are serious and impairing, and there are few effective therapies. Although 5-fluorouracil (5-FU) and intralesional triamcinolone acetonide (TAC) are widely used to manage both scars, their effectiveness is still debatable. To compare the efficacy of intralesional 5% FU versus intralesional triamcinolone in patients presenting with keloid and hypertrophic scar at Tertiary Care Hospital, Karachi. This RCT study was conducted on patients presenting with keloid and hypertrophic scars at the Outpatient Department of Dermatology, JPMC, Karachi, meeting inclusion criteria. A brief history of demographic information and written informed consent were taken from each patient. A total of 158 patients were enrolled in the study and were randomly allocated to Group A, Intralesional triamcinolone group, and B: Intralesional 5% FU group twice weekly for a total of 4 sessions. During each visit, the keloid height was measured, photographed again, and documented. Efficacy was labeled if patients with keloid and hypertrophic scar in either group showed ≥ 50% reduction in height. Comparison of efficacy between groups showed a significant difference as the efficacy rate was higher in patients treated with 5-FU 45mg as compared to the patients administrated with TAC 10mg (70.9% vs. 50.6%; P-value=0.009). This analysis revealed that irrespective of the patient's age, sex, illness duration, or lesion site, intra-lesional 5-fluorouracil (5-FU) offered the significant benefit of a faster and more effective response than triamcinolone (TAC) in the treatment of keloids and hypertrophic scars.
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卡拉奇第三级护理医院对瘢痕疙瘩和增生性瘢痕患者使用 5%肤轻松和曲安奈德的疗效比较
尽管瘢痕疙瘩和增生性疤痕是真皮成纤维细胞经常出现的良性过度增生,但其带来的生理和心理问题等临床问题却严重影响患者的身心健康,而且有效的治疗方法很少。虽然 5-氟尿嘧啶(5-FU)和醋酸曲安奈德三苯氧胺(TAC)被广泛用于治疗这两种疤痕,但其疗效仍有待商榷。本研究旨在比较卡拉奇三级医院对瘢痕疙瘩和增生性疤痕患者使用 5% FU 和曲安奈德的疗效。这项 RCT 研究的对象是卡拉奇 JPMC 皮肤科门诊部符合纳入标准的瘢痕疙瘩和增生性疤痕患者。研究人员向每位患者了解了简短的病史和人口统计学信息,并征得了患者的书面知情同意。共有 158 名患者参加了研究,并被随机分配到 A 组(曲安奈德内注射组)和 B 组(5% FU 内注射组),每周两次,共 4 次治疗。每次就诊时,测量瘢痕疙瘩的高度,再次拍照并记录。如果两组瘢痕疙瘩和增生性瘢痕患者的瘢痕高度均降低了 50%,则判定为有效。组间疗效比较显示,5-FU 45 毫克治疗患者的有效率高于 TAC 10 毫克治疗患者(70.9% 对 50.6%;P 值=0.009),差异显著。这项分析表明,在治疗瘢痕疙瘩和增生性疤痕方面,无论患者的年龄、性别、病程或病变部位如何,皮损内注射 5-氟尿嘧啶(5-FU)都比曲安奈德(TAC)更快、更有效。
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