Laser-assisted topical steroid application versus steroid injection for treating keloids: A split side study.
fractional laser
intralesional steroid injection
keloids
scars
Journal
Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
01
05
2020
accepted:
26
05
2020
pubmed:
3
6
2020
medline:
15
5
2021
entrez:
3
6
2020
Statut:
ppublish
Résumé
Approaches to improve keloid scars include intralesional corticosteroid injections and fractional lasers exclusively. The combinative use of ablative fractional laser therapy and occluded topical corticosteroid as a drug delivery method enhances therapeutic outcome of two efficient scar therapy modules into one simple synergistic module. To compare the therapeutic effect of combining two modalities of scar treatment, the first is fractional ablative laser treatment and the other is occluded topical corticosteroid to the standard use of intralesional steroid injection. Keloids from thirty suffering patients were split faced into two identical parts; one part received an intralesional corticosteroid injection while the other part was treated first with fractional ablative 2940 nm Er: YAG laser followed by occluded topical application of steroid cream. Four treatment sessions were performed with 4-week interval between sessions. Every session was assessed photographically and using the Vancouver Scar Scale (VSS). The mean keloid VSS before treatment was 6.9 ± 1.9. After treatment, the mean keloid VSS of the injection side became 2.63 ± 2.09, and mean keloid VSS of the laser-treated side became 2.07 ± 2.02. Each of the treated halves showed a statistically significant improvement in their VSS. However, no statistically significant differences were observed for either of the treated halves over the other one. Although intralesional steroids injection is the standard procedure for treatment of keloid scars, the use of ablative fractional laser-assisted delivery of topical steroid can offer a safer and a better aesthetic treatment option.
Sections du résumé
BACKGROUND
BACKGROUND
Approaches to improve keloid scars include intralesional corticosteroid injections and fractional lasers exclusively. The combinative use of ablative fractional laser therapy and occluded topical corticosteroid as a drug delivery method enhances therapeutic outcome of two efficient scar therapy modules into one simple synergistic module.
AIM
OBJECTIVE
To compare the therapeutic effect of combining two modalities of scar treatment, the first is fractional ablative laser treatment and the other is occluded topical corticosteroid to the standard use of intralesional steroid injection.
METHODS
METHODS
Keloids from thirty suffering patients were split faced into two identical parts; one part received an intralesional corticosteroid injection while the other part was treated first with fractional ablative 2940 nm Er: YAG laser followed by occluded topical application of steroid cream. Four treatment sessions were performed with 4-week interval between sessions. Every session was assessed photographically and using the Vancouver Scar Scale (VSS).
RESULTS
RESULTS
The mean keloid VSS before treatment was 6.9 ± 1.9. After treatment, the mean keloid VSS of the injection side became 2.63 ± 2.09, and mean keloid VSS of the laser-treated side became 2.07 ± 2.02. Each of the treated halves showed a statistically significant improvement in their VSS. However, no statistically significant differences were observed for either of the treated halves over the other one.
CONCLUSION
CONCLUSIONS
Although intralesional steroids injection is the standard procedure for treatment of keloid scars, the use of ablative fractional laser-assisted delivery of topical steroid can offer a safer and a better aesthetic treatment option.
Substances chimiques
Steroids
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
138-142Informations de copyright
© 2020 Wiley Periodicals, LLC.
Références
Trisliana Perdanasari A, Lazzeri D, Su W, et al. Recent developments in the use of intralesional injections keloid treatment. Arch Plast Surg. 2014;41(6):620-629.
Berman B, Maderal A, Raphael B. Keloids and hypertrophic scars. Dermatol Surg. 2017;1:S3-S18.
Park JH, Chun JY, Lee JH. Laser-assisted topical corticosteroid delivery for the treatment of keloids. Lasers Med Sci. 2017;32(3):601-608.
Cavalié M, Sillard L, Montaudié H, Bahadoran P, Lacour JP, Passeron T. Treatment of keloids with laser-assisted topical steroid delivery: a retrospective study of 23 cases. Dermatol Ther. 2015;28:74-78.
Almukhtar R, Lee B, LeBlanc K. (2017). Use of Laser-assisted Topical Steroid Delivery for Treatment of Hypertrophic Scars and Keloids. Annual Meeting of the American Society for Dermatologic Society. Chicago, IL. 5-8 October 2017. 172.
Nicholas R, Falvey H, Lemonas P, et al. Patient-related keloid scar assessment and outcome measures. Plast Reconstr Surg. 2012;129(3):648-656.
Nor NM, Ismail R, Jamil A, Shah SA, Imran FH. A randomized, single-blind trial of clobetasol propionate 0.05% cream under silicone dressing occlusion versus intralesional triamcinolone for treatment of keloid. Clin Drug Investig. 2017;37(3):295-301.
Waibel JS, Wulkan AJ, Shumaker PR. Treatment of hypertrophic scars using laser and laser assisted corticosteroid delivery. Lasers Surg Med. 2013;45:135-140.
Haedersdal M. Fractional ablative CO2 laser resurfacing improves a thermal burn scar. J Eur Acad Dermatol Venereol. 2009;23:1340-1341.
Azzam O, Bassiouny D, El-Hawary M, El Maadawi Z, Sobhi R, El-Mesidy M. Treatment of hypertrophic scars and keloids by fractional carbon dioxide laser: a clinical, histological, and immunohistochemical study. Lasers Med Sci. 2016;31(1):9-18.
Niwa ABN, Mello APF, Torezan LA, et al. Fractional photothermolysis for the treatment of hypertrophic scars: clinical experience of eight cases. Dermatol Surg. 2009;35:773-778.
Gauglitz G, Korting H, Pavicic T, Ruzicka T, Jeschke MG. Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med. 2011;17(1-2):113-125.