Intralesional pentoxifylline, triamcinolone acetonide, and their combination for treatment of keloid 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:
Oct 2021
Historique:
revised: 24 05 2021
received: 24 02 2021
accepted: 14 06 2021
pubmed: 18 6 2021
medline: 21 10 2021
entrez: 17 6 2021
Statut: ppublish

Résumé

Keloids are common fibroproliferative tumors, and their treatment still represents a dilemma. Intralesional triamcinolone acetonide (TAC) injection is effective, but frequently associated with side effects. Pentoxifyllin (PTX) is a vasodilator, anti-inflammatory, and antifibrotic agent. Its intralesional injection in keloids has not been evaluated yet. Evaluating the efficacy and safety of intralesional PTX versus intralesional TAC and their combination for treatment of keloids. Thirty patients with keloids were divided into three equal groups and treated by intralesional injection of TAC, PTX, or their combination (admixed in 1:1 ratio). Injections were repeated every 3 weeks until lesional flattening or for maximum of 5 sessions. The evaluation was done using the Vancouver Scar Scale and the Verbal Rating Scale for pain and itching. A significant improvement in VSS was detected in all groups. Significantly better improvements in keloid height, pliability, pain, and itching were detected in the TAC and combination groups than in the PTX group. There was a significantly higher incidence of side effects (atrophy, hypopigmentation, telangiectasia, and precipitation of TAC) in the TAC group than in the combination group, while no side effects were reported in the PTX group. A statistically significant reduction in the number of treatment sessions (required to achieve best results) was detected in patients in the combination group. Intralesional injection of PTX is a potentially helpful, safe, and well-tolerated therapeutic tool for keloids, but with lower efficacy than intralesional TAC when used solely. Combining PTX and TAC produces significantly better results for keloid treatment and lowers the risk of TAC-induced side effects.

Sections du résumé

BACKGROUND BACKGROUND
Keloids are common fibroproliferative tumors, and their treatment still represents a dilemma. Intralesional triamcinolone acetonide (TAC) injection is effective, but frequently associated with side effects. Pentoxifyllin (PTX) is a vasodilator, anti-inflammatory, and antifibrotic agent. Its intralesional injection in keloids has not been evaluated yet.
AIMS OBJECTIVE
Evaluating the efficacy and safety of intralesional PTX versus intralesional TAC and their combination for treatment of keloids.
PATIENTS/METHODS METHODS
Thirty patients with keloids were divided into three equal groups and treated by intralesional injection of TAC, PTX, or their combination (admixed in 1:1 ratio). Injections were repeated every 3 weeks until lesional flattening or for maximum of 5 sessions. The evaluation was done using the Vancouver Scar Scale and the Verbal Rating Scale for pain and itching.
RESULTS RESULTS
A significant improvement in VSS was detected in all groups. Significantly better improvements in keloid height, pliability, pain, and itching were detected in the TAC and combination groups than in the PTX group. There was a significantly higher incidence of side effects (atrophy, hypopigmentation, telangiectasia, and precipitation of TAC) in the TAC group than in the combination group, while no side effects were reported in the PTX group. A statistically significant reduction in the number of treatment sessions (required to achieve best results) was detected in patients in the combination group.
CONCLUSIONS CONCLUSIONS
Intralesional injection of PTX is a potentially helpful, safe, and well-tolerated therapeutic tool for keloids, but with lower efficacy than intralesional TAC when used solely. Combining PTX and TAC produces significantly better results for keloid treatment and lowers the risk of TAC-induced side effects.

Identifiants

pubmed: 34138506
doi: 10.1111/jocd.14305
doi:

Substances chimiques

Triamcinolone Acetonide F446C597KA
Pentoxifylline SD6QCT3TSU

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3330-3340

Informations de copyright

© 2021 Wiley Periodicals LLC.

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Auteurs

Yasmin Magdy Abdulrahman Serag-Eldin (YMA)

Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Wael Hussein Mahmoud (WH)

Plastic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Mohamed Mahmoud Gamea (MM)

Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Doaa Salah Hegab (DS)

Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

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