Treatment of small keloids with intralesional 5- fluorouracil alone vs. intralesional triamcinolone acetonide with 5-fluorouracil

Background Keloid is a benign well demarcated area of dense, fibrous tissue overgrowth that extends beyond the original defect. Objective To compare the efficacy of intralesional 5-fluorouracil (5-FU) alone vs. intralesional triamcinolone acetonide (TAC) in combination with 5-fluorouracil. Patients and methods Study on 50 clinically diagnosed lesions of keloids from 28 patients was conducted. In group A, 25 keloid lesions were subjected to 50 mg/ml 5-FU intralesionally while in group B, 25 keloid lesions were injected intralesionally with a combination of 40 mg/ml triamcinolone acetonide (0.1 ml) and 5-FU 50mg/ml (0.9 ml). Both the procedures were repeated at weekly intervals for 4 weeks, then bimonthly for 2 months and then monthly until the keloid lesions in both groups virtually assumed the same level as that of surrounding tissue or for a maximum of 3 months. Results Good to excellent response was seen in 96% cases in group B in contrast to 72% cases only in group A. The group B lesions showed better improvement than group A lesions in pruritus, pain, tenderness, restriction of movements and cosmetic problem. No recurrence was seen in any of the lesions. Conclusion The combination of 5-FU and triamcinolone acetonide is a better modality of treatment of small keloids compared with 5-FU alone