Comparison of Therapeutic Response of Keloids to Cryotherapy Plus Intralesional Triamcinolone Acetonide or Verapamil Hydrochloride

A keloid is dysregulated fibroproliferative scar tissue in response to skin injuries, which extends beyond the wound margin. Since it has a poor response to treatment, variable therapies are used. Current therapies of keloid include intralesional corticosteroid injection, cryotherapy and various laser therapies, silicone gel sheets (pressure therapy), interferon-α-2b, 5-fluoruracil or bleomycine administration, excision followed by low dose radiation or topical imiquimod. The aim of this study was to compare the efficacy and safety of “intralesional triamcinolone with cryotherapy” and “Intralesional verapamil with cryotherapy”. Eighty patients (42 females and 38 males, aged 11 - 40 years) were allocated to receive one of the four treatment methods. Group 1: Intralesional triamcinolone with cryotherapy. Group 2: Intralesional verapamil with cryotherapy. Group 3: Intralesional verapamil. Group 4: Cryotherapy. Improvement of healing was measured using modified Vancouver scar scale and centimeter scale. There was a real faster response in the first group; while groups 3 and 4 had the slowest responses to treatment. Rates of responsiveness seemed to have no significant difference between the groups, but side effects were significantly much frequent in the first group. Intralesional triamcinolone acetonide with cryotherapy showed the most efficacies with more adverse effects, but intralesional verapamil with cryotherapy showed good efficacy with less adverse effects. Hence, it is a suitable alternative in the treatment of keloids.