Keloids treatment with 585 nm pulsed dye laser with 5-fluorouracil and corticosteroid intralesionally

الملخص EN

Objective: Estimate the efficacy of combination of 585 nm pulsed dye laser with 5-fluorouracil and corticosteroid intralesionally in the treatment of keloids.

Methods: A total of 45 patients with keloids were treated with a combination of 585 nm pulsed dye laser, intralesional 5- fluorouracil (5-FU, 40 mg/ml) and intralesional triamcinolone acetonide (TAC, 8 mg/ml) every 4 weeks for a total of 7 sessions.

Results: All patients achieved more than 50% improvement in all scar aspects, there was no case of unresponsive or poor response.

The most obvious improvement was reported in the pruritus score that achieved excellent results in all the 45 patients (45 patients, 100%), followed by the excellent improvement in the pliability score (42 patients, 93.3%), and erythema score (42 patients, 93.3%), then an excellent flattening that was achieved in 32 patients (71.1%) including 42.2% of complete flattening.

The most common side effects were mild to moderate discomfort or pain in 40 patients (88.9%) during laser pulsing, mild to moderate pain during injection in 100% of patients, spots of purpura in 23 patients (51.1%), and 2 cases of localized superficial tissue slough (4.45%), 4 cases (8.89%) of erosions secondary to blistering, and 4 cases (8.89%) of hypopigmentation.

No cases of skin atrophy, telangiectasia or hyperpigmentation was reported.

Conclusions: This combination illustrates the success of multifaceted approach in treatment of hypertrophic scars and keloids with minimal side effects and improvement of the skin texture.