Comparison of efficacy and safety of intralesional
triamcinolone and combination of triamcinolone
with 5-fluorouracil in the treatment of keloids and
hypertrophic scars: Randomised control trial
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Farrukh Aslam Khalid * , Muhammad Younas Mehrose,
Muhammad Saleem, Muhammad Amin Yousaf, Abdul Malik Mujahid,
Saif Ur Rehman, Sania Ahmad, Moazzam Nazeer Tarar
Jinnah Burn and Reconstructive Surgery Center, Allama Iqbal Medical College, Lahore, Pakistan
a b s t r a c t
The treatment of keloid and hypertrophic scar is challenging with no universally accepted
mode for permanent ablation. Conventional therapies yield unpredictable results, signifi-
cant complications and require elaborate hardware.
Objective: The objective was to establish the safety and efficacy of intralesional 5-fluorouracil
(5-FU) for the treatment of keloids and hypertrophic scars.
Study design: Randomized controlled trial (RCT).
Place and duration: It was conducted at the Jinnah Burn and Reconstructive Surgery Center/
Allama Iqbal Medical College, Lahore, Pakistan from May 2012 to March 2013.
Subjects and methods: We included 120 patients divided in two groups. The group A patients
received intralesional triamcinolone acetonide (TAC) and the group B patients received both
5-FU and TAC. 8 injections at a week interval were given and patients were evaluated at the
start of treatment and then at 4th and at 8th week during the treatment and then 4 weeks
after the end of treatment. Patents were assessed for mean reduction in scar height, efficacy
and complications.
Results: Total of 108 patients completed the study. The mean reduction in the scar height in
group B (5-FU+TAC) 1.144+.4717 was markedly better than that of group A (TAC alone) 1.894
+ 1.0751 (t=4.781, p=.000). The efficacy (defined previously as >50% reduction in initial scar
height) was superior in group B 44 (77.2%) than that of group A 25 (49.0% (X2=9.260, p=.002).
Recurrence was seen in 39.2% (20) of patients of the group A while in only 17.5% (10) of the
cases of group B (P=0.012). Mean follow up was of 22 months.
Conclusion: 5-FU+TAC is safe, easy to administer and effective treatment for problematic
scars and has the lower rate of recurrence on larger follow up.
© 2018 Elsevier Ltd and ISBI. All rights reserved.
a r t i c l e i n f o
Article history:
Accepted 7 August 2018
Available online xxx
Keywords:
Keloid
Hypertrophic scar
5-Fluorouracil
Double blind
Randomized control trial
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Poster presentation at the International Society of Burn Injuries, August, 2016 at Miami, Florida, USA.
* Corresponding author.
E-mail address: drfarrukhaslam@gmail.com (F.A. Khalid).
https://doi.org/10.1016/j.burns.2018.08.011
0305-4179/© 2018 Elsevier Ltd and ISBI. All rights reserved.
b u r n s x x x ( 2 0 1 8 ) x x x – x x x
JBUR 5615 No. of Pages 7
Please cite this article in press as: F.A. Khalid, et al., Comparison of efficacy and safety of intralesional triamcinolone and combination
of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: Randomised control trial, Burns (2018),
https://doi.org/10.1016/j.burns.2018.08.011
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