Surgical excision and immediate postoperative radiotherapy versus cryotherapy and intralesional steroids in the management of keloids: a prospective clinical trial.
OBJECTIVE
To compare the efficacy and tolerability of surgical excision and radiotherapy with those of cryotherapy and intralesional steroid treatment of keloids.


METHODS
Twenty-six patients with a total of 76 keloids were enrolled in this study. Nineteen patients with 44 keloids underwent surgical excision combined with immediate 12-Gy irradiation (group A) while the remaining 9 patients with 32 keloids received multiple sessions of intralesional steroid treatment after cryotherapy which continued until flattening of lesion(s) occurred (group B). Two patients were included in both treatment groups. All patients were followed up at regular intervals for at least 1 year.


RESULTS
In both treatment groups, keloids responded well without any major side effect. While patients of group A were all satisfied, those of group B (with a mean number of treatment sessions of 5.84 +/- 2.51) experienced more side effects, a more prolonged course, a higher recurrence rate and less satisfaction.


CONCLUSIONS
This study showed that surgery plus immediate postoperative irradiation was an effective and relatively safe choice for treatment of keloids. Although cryotherapy combined with intralesional steroids was associated with more side effects and higher relapse rates, it could be a good choice for small and newly formed keloids.
Emad
Maryam
M
Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran.
Omidvari
Shapour
S
Dastgheib
Ladan
L
Mortazavi
Afshin
A
Ghaem
Haleh
H
D000293:Adolescent; D000328:Adult; D017679:Cryotherapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D055815:Young Adult
D005938:Glucocorticoids