Mechanical properties of keloids in vivo during treatment with intralesional triamcinolone acetonide.
The mechanical properties of 17 keloids in 9 patients before and during treatment with intralesional triamcinolone acetonide were studied using a recently developed noninvasive suction device for measuring skin elasticity in vivo. Each keloid was treated with intralesional injections of 10 mg/ml triamcinolone acetonide without local anaesthetic at intervals of 3 weeks. A total of four measurements per keloid were performed, before treatment and 3 weeks after the first, second and third treatments. The parameters used were: immediate distension (Ue), delayed distension (Uv), immediate retraction (Ur) and final distension (Uf). Relative parameters independent of skin thickness were calculated: Uv/Ue, the ratio between the viscous and the elastic deformation of the skin, and Ur/Uf, representing the ability of the skin to return to its initial position after deformation (biological elasticity). After three injections of triamcinolone acetonide a marked decrease in Uv/Ue and a less-pronounced increase in Ur/Uf compared with baseline values was observed. These findings indicate that the main effect of intralesional steroids on the connective tissue of keloids is a decrease in viscosity due to a loss of ground substance. This method provides a noninvasive quantitative assessment of the mechanical properties of scars and is well suited to comparative studies on the efficacy of various scar therapies.
Krusche
T
T
Dermatologische Klinik, Technischen Universität München, Germany.
Worret
W I
WI
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D004548:Elasticity; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D013396:Suction; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014783:Viscosity
D014222:Triamcinolone Acetonide