[Clinical study of auricular keloid treatment with both surgical excision and intralesional injection of low-dose 5-fluorouracil and corticosteroids].
OBJECTIVE
To investigate whether intralesional injection of low-dose 5-fluorouracil (5-Fu) and corticosteroid can increase effective rate and decrease recurrence rate of surgically removed auricular keloid.


METHODS
Eighty-three patients with 166 total ear keloids were studied, including 79 keloids of helix and 87 of earlobe with an average disease history of 2.9 years. Ear piercing accounted for 92.7% for etiology. Keloids were first surgically removed in order to keep the normal auricular shape. Then intralesional injection of low-dose of 5-Fu and corticosteroid was given 3 - 4 weeks after surgery and every 4 weeks afterwards. If no recurrence, the injection was given every 2 to 3 months with gradually tapered dose. The evaluation standard includes: patients with no recurrence 6 months after stopping drug injection and maintaining of the normal auricular shape are considered as "cure"; those remain having minor auricular deformity 6 months post-surgery with no recurrence and needing further treatment are considered as "effective".


RESULTS
The treatment time period for 83 patients was 2 - 26 months (mean: 7 months). The patients were followed up for 0 - 49 months (mean: 9 months) after withdrawing drug injection. There were 39 cured cases (47.0%) and 44 effective cases (53%). The total effective rate was 100%. Normal auricular shapes were achieved in 77 cases (92.7%) .


CONCLUSIONS
Surgical removal of auricular keloid followed by intralesional injection of low-dose 5-Fu and steroid is an effective method to treat auricular keloid and prevent its relapse.
Wu
Xiao-Li
XL
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Gao
Zhen
Z
Song
Nan
N
Liu
Wei
W
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D003131:Combined Modality Therapy; D004431:Ear, External; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D005472:Fluorouracil