Comparison of Intralesional Triamcinolone Acetonide, 5-Fluorouracil, and Their Combination in Treatment of Keloids

BACKGROUND Despite the myriad options available, there is no universally accepted treatment for keloids. This study has compared intralesional triamcinolone acetonide, 5-fluorouracil, and their combination in treatment of keloids. METHODS In this randomized parallel group study, 60 patients were enrolled and randomly allocated to three groups. Patients received intralesional injections of triamcinolone acetonide (TAC) in Group TAC, 5-fluorouracil (5FU) in Group 5FU and a combination in Group T+F every 3 weeks till 24 weeks or till the keloid resolved.  RESULTS There was a reduction in all parameters at every successive assessment in all three groups. Improvement in terms of height, vascularity and pliability was fastest with 5FU, TAC and T+F group, respectively, which was statistically significant. Decrease in pigmentation was significantly faster with T+F. Reduction in pruritus, however, was significantly faster with 5FU than the other groups, but the difference in reduction of pain among the three groups was not significant. Telangiectasias and skin atrophy were seen most commonly in TAC group, while skin ulceration was a common problem in 5FU group. CONCLUSION TAC, 5FU and their combination are all effective in keloid scars. A combination of TAC+5FU seems to offer the balanced benefit of faster and more efficacious response with lesser adverse effects when compared to individual drugs.