title: Objective assessment of keloid scars with three-dimensional imaging: quantifying response to intralesional steroid therapy.
abstract: BACKGROUND
  Treatment of keloid scars poses a significant challenge. Assessment of treatment response and research in this area depend on the availability of objective, accurate, and reproducible outcome measures. At present, scars are assessed using subjective grading systems, or with cumbersome investigations such as direct casting. The authors assessed the feasibility of objectively monitoring response to intralesional steroid treatment in routine clinical practice with quantitative three-dimensional imaging.
  
  
  METHODS
  Scar volume was quantified using a validated three-dimensional speckle-pattern stereophotogrammetry before and for a minimum of 8 weeks after intralesional steroid therapy in 12 patients with keloid scars.
  
  
  RESULTS
  Mean scar volume at the start of treatment was 0.73 +/- 0.701 cc (range, 0.12 to 2.15 cc); this was reduced to 0.14 +/- 0.302 cc (range, 0.007 to 1.08 cc) after monthly intralesional injections of triamcinolone acetate (p < 0.001; analysis of variance). The majority of patients achieved a greater than 50 percent response within 8 weeks of the start of therapy, but poor treatment response was noted and quantified in a minority of patients.
  
  
  CONCLUSIONS
  Three-dimensional stereophotogrammetry is a rapid and noninvasive method of scar volume assessment that could allow accurate and objective monitoring of treatment response to be incorporated into clinical practice. Therefore, it can be of considerable value in assessing treatment efficacy and evaluating new therapeutic strategies.
authors.affiliation: Department of Plastic Surgery, Charing Cross Hospital, London, UK. ardehali@hotmail.com
authors.forename: Ben
authors.initials: B
authors.lastname: Ardehali
authors.forename: S A Reza
authors.initials: SA
authors.lastname: Nouraei
authors.forename: Helena
authors.initials: H
authors.lastname: Van Dam
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dex
authors.forename: Simon
authors.initials: S
authors.lastname: Wood
authors.forename: Charles
authors.initials: C
authors.lastname: Nduka
mesh_terms: D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D021621:Imaging, Three-Dimensional; D015552:Injections, Intralesional; D007627:Keloid / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010780:Photogrammetry / Q000379:methods*; D014221:Triamcinolone / Q000008:administration & dosage*
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone