Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids.
BACKGROUND
The calcium channel blocker, verapamil stimulates procollagenase synthesis in keloids and hypertrophic scars.


OBJECTIVE
To study the effect of verapamil in the treatment of hypertrophic scars and keloids and to evaluate the effect of verapamil on the rate of reduction of hypertrophic scars and keloids in comparison with triamcinolone.


METHODS
The study was a randomized, single blind, parallel group study in which 54 patients were allocated to to receive either verapamil or triamcinolone. Drugs were administered intralesionally in both groups. Improvement of the scar was measured using modified Vancouver scale and by using a centimeter scale serially till the scar flattened.


RESULTS
There was a reduction in vascularity, pliability, height and width of the scar with both the drugs after 3 weeks of treatment. These changes were present at one year of follow-up after stopping treatment. Scar pigmentation was not changed desirably by either drug. Length of the scars was also not altered significantly by either drug. The rate of reduction in vascularity, pliability, height and width of the scar with triamcinolone was faster than with verapamil. Adverse drug reactions were more with triamcinolone than with verapamil.


CONCLUSIONS
Intralesional verapamil may be a suitable alternative to triamcinolone in the treatment of hypertrophic scars and keloids.
Margaret Shanthi
F X
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Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India. drmaggi29@gmail.com
Ernest
Kalpana
K
Dhanraj
Prema
P
D000293:Adolescent; D000328:Adult; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D017439:Cicatrix, Hypertrophic / Q000188:drug therapy* / Q000473:pathology; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D016037:Single-Blind Method; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D014700:Verapamil / Q000008:administration & dosage* / Q000009:adverse effects; D055815:Young Adult
D002121:Calcium Channel Blockers; D005938:Glucocorticoids; D014700:Verapamil; D014222:Triamcinolone Acetonide