5-Fluorouracil treatment of problematic scars.
BACKGROUND
Keloids and hypertrophic scars can be uncomfortable, disfiguring, and aesthetically undesirable. Anecdotal reports suggest that low-dose intralesional fluorouracil can be used to treat these undesirable scars.


METHODS
Using a prospective case series protocol, both keloid and hypertrophic scar patients were included. Keloid patients underwent excision followed by a series of treatments with intralesional 5-fluorouracil into the healing scar to prevent recurrence (n = 32). The hypertrophic scar patients were treated with the same series of injections without scar excision to both control symptoms and improve scar appearance (n = 21). The primary outcome measures were scar volume and a symptom questionnaire. Patients were followed for 1 year after completing the injection treatments.


RESULTS
In the keloid group, the recurrence rate was 19 percent at 1-year follow-up for this group of patients who had failed previous corticosteroid injection therapy. In the hypertrophic scar group, 14 percent did not respond to the series of injections. In this group, there was a median volume decrease of 50 percent maintained for 1 year after injection therapy was terminated.


CONCLUSIONS
Intralesional fluorouracil is a safe and effective means of controlling problem scars in terms of both recurrence and symptom control. Benefits were maintained for at least 1 year after completion of therapy. Intralesional 5-fluorouracil should be considered another option for patients suffering from problematic scars.
Haurani
Mounir J
MJ
Detroit, Mich.; and Huntsville, Ala. From the Departments of Surgery and Biostatistics and Research Epidemiology and the Division of Plastic Surgery, Henry Ford Hospital; and Alabama Surgical Associates.
Foreman
Kenneth
K
Yang
James J
JJ
Siddiqui
Aamir
A
D000328:Adult; D000963:Antimetabolites / Q000627:therapeutic use*; D017439:Cicatrix, Hypertrophic / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007627:Keloid / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000963:Antimetabolites; D005472:Fluorouracil