Treatment of an ear keloid refractory to intralesional triamcinolone injection monotherapy with fractional CO2 laser and triamcinolone combination therapy: a case report
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Keloid is a benign fibroproliferative disorder characterized by excessive collagen production during abnormal wound healing in keloid-prone individuals. Therefore, the treatment of keloid aims to reduce inflammation and reorganize collagen bundles. Intralesional corticosteroid injection, particularly triamcinolone, is a common first-line treatment, but injections can be difficult in very firm lesions. This case report presents a refractory ear keloid treated with a combination therapy of fractional ablative CO2 laser and intralesional triamcinolone injection. The patient had a persistent keloid mass in her left ear despite previous intralesional corticosteroid injections. The ear keloid was treated with the combination therapy of fractional CO2 laser and triamcinolone injection. The keloid size was reduced by more than 50%, and the Vancouver Scar Scale score improved. Combined fractional CO2 laser and triamcinolone injections may have a synergistic effect on drug delivery in addition to each keloid improvement.
Abstract
Keloid is a benign fibroproliferative disorder characterized by excessive collagen production during abnormal wound healing in keloid-prone individuals. Therefore, the treatment of keloid aims to reduce inflammation and reorganize collagen bundles. Intralesional corticosteroid injection, particularly triamcinolone, is a common first-line treatment, but injections can be difficult in very firm lesions. This case report presents a refractory ear keloid treated with a combination therapy of fractional ablative CO2 laser and intralesional triamcinolone injection. The patient had a persistent keloid mass in her left ear despite previous intralesional corticosteroid injections. The ear keloid was treated with the combination therapy of fractional CO2 laser and triamcinolone injection. The keloid size was reduced by more than 50%, and the Vancouver Scar Scale score improved. Combined fractional CO2 laser and triamcinolone injections may have a synergistic effect on drug delivery in addition to each keloid improvement.
참고문헌 (15)
- Limandjaja GC, "The keloid disorder : heterogeneity, histopathology, mechanisms and models", Front Cell Dev Biol, 8, pp.360~ (2020)
- Ogawa R, "The most current algorithms for the treatment and prevention of hypertrophic scars and keloids: a 2020 update of the algorithms published 10 years ago", Plast Reconstr Surg, 149, pp.79e~94e (2020)
- Sullivan T, "Rating the burn scar", J Burn Care Rehabil, 11, pp.256~260 (1990)
- Betarbet U, "Keloids : a review of etiology, prevention, and treatment", J Clin Aesthet Dermatol, 13, pp.33~43 (2020)
- Yang S, "Common dermatologic procedures", Med Clin North Am, 99, pp.1305~1321 (2015)
- Carroll LA, "Triamcinolone stimulates bFGF production and inhibits TGFbeta1production by human dermal fibroblasts", Dermatol Surg, 28, pp.704~709 (2002)
- Euler T, "Normal and keloid fibroblasts are differentially influenced by IFN-γ and triamcinolone as well as by their combination", Wound Repair Regen, 27, pp.450~461 (2019)
- Syed F, "Fibroblasts from the growing margin of keloid scars produce higher levels of collagen I and III compared with intralesional and extralesional sites : clinical implications for lesional sitedirected therapy", Br J Dermatol, 164, pp.83~96 (2011)
- Oosterhoff TCH, "Laser treatment of specific scar characteristics in hypertrophic scars and keloid : a systematic review", J Plast Reconstr Aesthet Surg, 74, pp.48~64 (2021)
- Tawfic SO, "Evaluation of fractional CO2 versus long pulsed Nd : YAG lasers in treatment of hypertrophic scars and keloids : a randomized clinical trial", Lasers Surg Med, 52, pp.959~965 (2020)
- Soliman M, "Comparative study between Nd-YAG laser, fractional CO2laser, and combined Nd-YAG with fractional CO2 laser in the management of keloid : clinical and molecular study", J Cosmet Dermatol, 20, pp.1124~1132 (2021)
- Azzam OA, "Treatment of hypertrophic scars and keloids by fractional carbon dioxide laser : a clinical, histological, and immunohistochemical study", Lasers Med Sci, 31, pp.9~18 (2016)
- Kuo YR, "Flashlamp pulsed-dye laser suppressed TGF-beta1 expression and proliferation in cultured keloid fibroblasts is mediated by MAPK pathway", Lasers Surg Med, 39, pp.358~364 (2007)
- Kim DH, "A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars", Dermatol Surg, 40, pp.973~978 (2014)
- Al Janahi S, "Laser-assisted drug delivery in the treatment of keloids : a case of extensive refractory keloids successfully treated with fractional carbon dioxide laser followed by topical application and intralesional injection of steroid suspension", JAAD Case Rep, 5, pp.840~843 (2019)