Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial
Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomize...
Gespeichert in:
| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2019-01, Vol.72 (1), p.4-11 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 11 |
|---|---|
| container_issue | 1 |
| container_start_page | 4 |
| container_title | Journal of plastic, reconstructive & aesthetic surgery |
| container_volume | 72 |
| creator | Hietanen, KE Järvinen, TA Huhtala, H Tolonen, TT Kuokkanen, HO Kaartinen, IS |
| description | Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months.
There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p |
| doi_str_mv | 10.1016/j.bjps.2018.05.052 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2135635418</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1748681518302195</els_id><sourcerecordid>2135635418</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-2dd710d971b5827fe9301c7578d11efd52c5dc5d5e9fbd64d2e469d70723d86b3</originalsourceid><addsrcrecordid>eNp9kMFq3DAQhkVp6CabvkAPRcdevJFkyZKhlxDSJBDIJTkLWRpTubK1leyW5JR36BvmSaplNzkGfpg5fPPDfAh9oWRDCW3Ohk03bPOGEao2RJSwD-iYKqkqIur2Y9klV1WjqFihk5wHQnhNufiEVjXhXDHeHKOn-wRmHmGacezxLwjRO5ytSRn_9fNP7Kc5mQDZx8kEPCdvRuunGOIE2EwOi6oPS0xxScb6UPAB7FzgjF-e_2GDU4Hi6J_AYRtLVwyhrLuecIqOehMyfD7MNXr4cXl_cV3d3l3dXJzfVpYTMlfMOUmJayXthGKyh7Ym1EohlaMUeieYFa5EQNt3ruGOAW9aJ4lktVNNV6_Rt33vNsXfC-RZjz5bCMFMEJesGa1FUwtOVUHZHrUp5pyg19vkR5MeNSV651wPeudc75xrIkpYOfp66F-6EdzbyavkAnzfA1C-_OMh6Ww9TBacT8WWdtG_1_8f1JSWRA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2135635418</pqid></control><display><type>article</type><title>Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial</title><source>Elsevier ScienceDirect Journals Complete</source><creator>Hietanen, KE ; Järvinen, TA ; Huhtala, H ; Tolonen, TT ; Kuokkanen, HO ; Kaartinen, IS</creator><creatorcontrib>Hietanen, KE ; Järvinen, TA ; Huhtala, H ; Tolonen, TT ; Kuokkanen, HO ; Kaartinen, IS</creatorcontrib><description>Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months.
There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p < 0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p < 0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels, after treatment decreased in the TAC group, but not in the 5-FU group (p < 0.05). Fibroblast proliferation evaluated by Ki-67 staining significantly decreased in the TAC group (p < 0.05) but increased in the 5-FU group (p < 0.05).
TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2018.05.052</identifier><identifier>PMID: 30448246</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>5-fluorouracil ; Immunohistochemistry ; Keloid ; Scar treatment ; Triamcinolone</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2019-01, Vol.72 (1), p.4-11</ispartof><rights>2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-2dd710d971b5827fe9301c7578d11efd52c5dc5d5e9fbd64d2e469d70723d86b3</citedby><cites>FETCH-LOGICAL-c400t-2dd710d971b5827fe9301c7578d11efd52c5dc5d5e9fbd64d2e469d70723d86b3</cites><orcidid>0000-0003-1372-430X ; 0000-0003-2029-6497</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1748681518302195$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30448246$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hietanen, KE</creatorcontrib><creatorcontrib>Järvinen, TA</creatorcontrib><creatorcontrib>Huhtala, H</creatorcontrib><creatorcontrib>Tolonen, TT</creatorcontrib><creatorcontrib>Kuokkanen, HO</creatorcontrib><creatorcontrib>Kaartinen, IS</creatorcontrib><title>Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months.
There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p < 0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p < 0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels, after treatment decreased in the TAC group, but not in the 5-FU group (p < 0.05). Fibroblast proliferation evaluated by Ki-67 staining significantly decreased in the TAC group (p < 0.05) but increased in the 5-FU group (p < 0.05).
TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas.</description><subject>5-fluorouracil</subject><subject>Immunohistochemistry</subject><subject>Keloid</subject><subject>Scar treatment</subject><subject>Triamcinolone</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kMFq3DAQhkVp6CabvkAPRcdevJFkyZKhlxDSJBDIJTkLWRpTubK1leyW5JR36BvmSaplNzkGfpg5fPPDfAh9oWRDCW3Ohk03bPOGEao2RJSwD-iYKqkqIur2Y9klV1WjqFihk5wHQnhNufiEVjXhXDHeHKOn-wRmHmGacezxLwjRO5ytSRn_9fNP7Kc5mQDZx8kEPCdvRuunGOIE2EwOi6oPS0xxScb6UPAB7FzgjF-e_2GDU4Hi6J_AYRtLVwyhrLuecIqOehMyfD7MNXr4cXl_cV3d3l3dXJzfVpYTMlfMOUmJayXthGKyh7Ym1EohlaMUeieYFa5EQNt3ruGOAW9aJ4lktVNNV6_Rt33vNsXfC-RZjz5bCMFMEJesGa1FUwtOVUHZHrUp5pyg19vkR5MeNSV651wPeudc75xrIkpYOfp66F-6EdzbyavkAnzfA1C-_OMh6Ww9TBacT8WWdtG_1_8f1JSWRA</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Hietanen, KE</creator><creator>Järvinen, TA</creator><creator>Huhtala, H</creator><creator>Tolonen, TT</creator><creator>Kuokkanen, HO</creator><creator>Kaartinen, IS</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1372-430X</orcidid><orcidid>https://orcid.org/0000-0003-2029-6497</orcidid></search><sort><creationdate>201901</creationdate><title>Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial</title><author>Hietanen, KE ; Järvinen, TA ; Huhtala, H ; Tolonen, TT ; Kuokkanen, HO ; Kaartinen, IS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-2dd710d971b5827fe9301c7578d11efd52c5dc5d5e9fbd64d2e469d70723d86b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>5-fluorouracil</topic><topic>Immunohistochemistry</topic><topic>Keloid</topic><topic>Scar treatment</topic><topic>Triamcinolone</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hietanen, KE</creatorcontrib><creatorcontrib>Järvinen, TA</creatorcontrib><creatorcontrib>Huhtala, H</creatorcontrib><creatorcontrib>Tolonen, TT</creatorcontrib><creatorcontrib>Kuokkanen, HO</creatorcontrib><creatorcontrib>Kaartinen, IS</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hietanen, KE</au><au>Järvinen, TA</au><au>Huhtala, H</au><au>Tolonen, TT</au><au>Kuokkanen, HO</au><au>Kaartinen, IS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2019-01</date><risdate>2019</risdate><volume>72</volume><issue>1</issue><spage>4</spage><epage>11</epage><pages>4-11</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months.
There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p < 0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p < 0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels, after treatment decreased in the TAC group, but not in the 5-FU group (p < 0.05). Fibroblast proliferation evaluated by Ki-67 staining significantly decreased in the TAC group (p < 0.05) but increased in the 5-FU group (p < 0.05).
TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>30448246</pmid><doi>10.1016/j.bjps.2018.05.052</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1372-430X</orcidid><orcidid>https://orcid.org/0000-0003-2029-6497</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1748-6815 |
| ispartof | Journal of plastic, reconstructive & aesthetic surgery, 2019-01, Vol.72 (1), p.4-11 |
| issn | 1748-6815 1878-0539 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2135635418 |
| source | Elsevier ScienceDirect Journals Complete |
| subjects | 5-fluorouracil Immunohistochemistry Keloid Scar treatment Triamcinolone |
| title | Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections – a randomized controlled trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T17%3A21%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Treatment%20of%20keloid%20scars%20with%20intralesional%20triamcinolone%20and%205-fluorouracil%20injections%20%E2%80%93%20a%20randomized%20controlled%20trial&rft.jtitle=Journal%20of%20plastic,%20reconstructive%20&%20aesthetic%20surgery&rft.au=Hietanen,%20KE&rft.date=2019-01&rft.volume=72&rft.issue=1&rft.spage=4&rft.epage=11&rft.pages=4-11&rft.issn=1748-6815&rft.eissn=1878-0539&rft_id=info:doi/10.1016/j.bjps.2018.05.052&rft_dat=%3Cproquest_cross%3E2135635418%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2135635418&rft_id=info:pmid/30448246&rft_els_id=S1748681518302195&rfr_iscdi=true |