Tuesday, June 23, 2015

Treatment Options For Keloids

Types of keloids
Scar type
Characteristics
Maturation
Minor keloid
  • Focally raised
  • Pruritic
  • Extends beyond burn borders
  • May have genetic component for keloid development
  • Typical site: earlobes


  • May develop one year after burn
  • Does not regress spontaneously
  • Recurrence generally follows surgical excision 


Major keloid
  • Large (>0.5 cm)
  • Painful
  • Pruritic
  • Extends beyond burn borders over normal tissue
  • Can result even from minor trauma


  • Does not spontaneously regress 
  • Can continue to progress in size over the years



Available Product In HKGU
Generic name
Brand name
Triamcinolone Acetonide 40mg/ml Inj
Kenacort-A


Minor keloids (<0.5 cm)
  • Triamcinolone acetonide 10 to 40 mg/mL 
  • Repeated at four-week intervals
  • Intralesional corticosteroid injections are painful. For local anesthesia, EMLA cream may be applied under occlusion for 1.5 hours before injection
  • Second-line therapies, intralesional 5-FU in combination with intralesional corticosteroids (0.9 mL of 5-fluorouracil 50 mg/mL plus 0.1 mL of Triamcinolone acetonide 40 mg/mL)

Major keloids (>0.5cm)
  • Intralesional Triamcinolone acetonide 40 mg/mL 
  • Repeated at intervals of three to four weeks for four to six months
REFERENCE :
http://www.aafp.org/afp/2009/0801/p253.html
Indian Journal Of Dermatology, Venereology & Leprology
Uptodate

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