Experts compare effectiveness of triamcinolone injection combination therapy and monotherapy for keloid

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Illustration by Feri Fenoria

UNAIR NEWS – After conducting a research on the diagnostic method for the success of leprosy eradication, Dr. M. Yulianto Listiawan, SpKK (K), FINSDV, FAADV., in a team, conducted another research on Effectiveness of Triamcinolone Injection Combination Therapy and Monotherapy for Keloid.

In the presentation, he said that keloid is hyperplasia of benign skin fibrous tissue and scar tissue that grows beyond the initial wound limit. There are complaints such as pain and itching from it.

“Histopathological features showed dense fibroblasts and collagen bonds that appear throughout the thickness of the dermis. Apoptotic levels of fibroblasts in keloid is lower than normal skin, “he said.

Furthermore, according to him, excess collagen occurs due to an imbalance between the formation and degradation of extracellular matrix. Keloid, he said, is more often found in African, Asian and Latin American ethnicities. In fact, until now there has been no treatment that can cure keloid as a whole.

“The first-line therapy for keloid is intralesional corticosteroid injection, but it only shows good results for small, early-stage keloid. Second-line therapy, in the form of surgical excision, needs to be considered if there is no improvement after 12 months of first-line therapy,” he explained.

However, he continued, surgical therapy is not recommended as monotherapy because of the high recurrence of 50 to 100%. It can even get bigger after the surgery.

“Another second-line therapy that can be used is laser,” he said.

He said that the research his team conducted compared combination therapy of CO 2 fractional laser and intralesional triamcinolone acetonide injection with intralesional triamcinolone acetonide injection monotherapy in keloid patients. He also revealed that histopathological examination is rarely done in keloid studies, most of them only use scar scores.

“This study tries to prove that triamcinolone acetonide and combination therapy can reduce collagen density.Triamcinolone significantly reduced collagen density in the control and combination therapy groups, but the difference in degradation was not significant, “he said.

In the end, he confirmed that collagen density dropped significantly in a shorter time if keloid is treated with CO2 fractional laser and intralesional triamcinolone acetonide injection. He explained that combination therapy gave good results.

“Intralesional triamcinolone acetonide injection monotherapy remains the main keloid therapy, because combination therapy did not show a significant difference compared to intralesional triamcinolone acetonide injection monotherapy,” he concluded.

Author: Nuri Hermawan

Editor: Khefti Al Mawalia

Reference:

https://www.pagepress.org/journals/index.php/dr/article/view/8032M.

M. Yulianto Listiawan, Dwi Murtiastutik, Willy Sandhika, Brama Rachmantyo, Putri Hendria Wardhani (2019). Comparison between fractional CO2 laser-triamcinolone injection combination therapy and triamcinolone injection monotherapy for keloid. Dermatology Reports, 11(s1): 8032.

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