title: Laser-assisted topical corticosteroid delivery for the treatment of keloids.
abstract: Laser-assisted drug delivery has generated intense interest. The objectives of this study are to evaluate the clinical benefit of laser-assisted corticosteroid delivery and to compare this technique to corticosteroid intralesional injection, a standard treatment for keloids. Patients with keloids on the left shoulder after BCG vaccination were enrolled in this study. The entire lesion was first treated with an ablative fractional erbium-YAG laser. After this treatment, the lesion was divided into two halves. The first half received an intralesional injection of corticosteroid, whereas the second half received topical application of corticosteroids that were occluded for 3 hours. Four treatment sessions were conducted, with treatments occurring once every 6 weeks. Treatment outcomes were evaluated using the Vancouver Scar Scale (VSS). Pain was self-assessed by the patient during the procedure. The mean keloid VSS score before treatment was 8.59 ± 1.23 for the corticosteroid injection site and 8.31 ± 2.09 for the topical site. After treatment, the mean keloid VSS score was decreased on both sides (4.56 ± 1.09 vs 5.02 ± 0.87, respectively, P > 0.05). Patients rated their satisfaction level as "moderate" on both sides. However, the mean pain score was 1.1 out of 10 on the topical side versus 6.1 on the corticosteroid injection site. The combination of ablative fractional laser treatment and topical corticosteroid application is a promising modality for the treatment of keloids. Moreover, this procedure was not associated with any serious adverse reactions or unbearable pain.
authors.affiliation: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Chun
authors.affiliation: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. bell711@hanmail.net.|Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, 81 Ilwon Ro, KangNam Gu, 135-710, Seoul, Republic of Korea. bell711@hanmail.net.
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use*; D000328:Adult; D003131:Combined Modality Therapy; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007627:Keloid / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D057566:Self Report; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Fractional ablative laser; Intralesional injection; Keloids; Topical corticosteroid