Efficacy and safety of intralesional 5-fluorouracil in the treatment of keloids.
BACKGROUND
The treatment of keloids remains challenging. Cryosurgery and intralesional corticosteroids have been considered as the mainstream of therapy; however, the long-term use of corticosteroids has been found to be associated with serious side effects. Intralesional 5-fluorouracil (5-FU) has only been used in one study for the treatment of hypertrophic scars and keloids, mostly in combination with other treatments. The efficacy of 5-FU as an individual therapeutic agent is unknown.


OBJECTIVE
To evaluate the efficacy and safety of intralesional injections of 5-FU in the treatment of small keloid lesions.


METHODS
Twenty-four (12 male, 12 female) consecutive patients with keloids of 6 cm or less in their maximum dimension were treated with intralesional injections of 50-150 mg 5-FU per week for a maximum of 16 injections.


RESULTS
One third (8/24, 33.3%) of the patients showed more than 75% flattening of the keloid. Three out of 8 patients (with >75% flattening) required less than 16 (13, 13 and 15) injections for achieving the desired response. Overall, about half of the patients showed more than 50% flattening of the treated keloid. A correlation with the duration of keloid was found. Six (54.5%) out of 11 patients with keloids of < or =5 years duration, in contrast to only 2 (15.4%) out of 13 patients with keloids of >5 years duration showed more than 75% flattening (p < 0.05). Side effects included pain (all patients), hyperpigmentation (all patients) and ulceration (1 patient). No difference in peripheral blood count was noted before, during and after the therapy.


CONCLUSIONS
Intralesional 5-FU can be safely used for the management of small keloids of shorter duration.
Gupta
Somesh
S
Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. someshgupta@yahoo.com
Kalra
Amit
A
D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015552:Injections, Intralesional; D007627:Keloid / Q000188:drug therapy*; D008297:Male; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D005472:Fluorouracil