A comparison of the combined effect of cryotherapy and corticosteroid injections versus corticosteroids and cryotherapy alone on keloids: a controlled study.
BACKGROUND
Treatment modalities for keloids, which are commonly found in Asians, include intralesional corticosteroid injections and cryotherapy as well as a combination of these two modalities. Few studies have been performed in a controlled fashion to evaluate the efficacy of these treatments.


OBJECTIVE
A controlled study, to evaluate the combined effect of intralesional corticosteroid injection with cryotherapy vs. intralesional corticosteroid or cryotherapy alone.


METHODS
Ten patients completed the study: eight patients had at least three keloids and two had two keloids. Patients were treated for at least three sessions 4 weeks apart. The outcome of the lesions was compared between the treatments regarding the thickness of the lesion using a caliper and photographic assessment, and the presence of itch and pain before and after treatment using a visual analogue scale.


RESULTS
In terms of thickness, the keloids responded significantly better to combined cryotherapy and triamcinolone vs. triamcinolone alone or cryotherapy alone (P < 0.001). Pain intensity was significantly lowered with all treatment modalities; however, itch was lowered only with the combined treatment and intralesional corticosteroid alone. No significant side effects were noted with any of the treatments and no re-occurrence of keloids was noted with the combined therapy.


CONCLUSIONS
Combined injection of intralesional steroids with cryotherapy appears to be superior to other current modalities.
Yosipovitch
G
G
National Skin Centre, National Medical Research Council, Ministry of Health, Singapore. gil@nsc.gov.sg
Widijanti Sugeng
M
M
Goon
A
A
Chan
Y H
YH
Goh
C L
CL
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D017679:Cryotherapy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide