Efficacy of Interalesional Botulinum Toxin Type A vs Cryotherapy in Treatment of Keloids: Comparative Clinical, Histopathological and Immunohistochemical Study

Abstract Background Keloid is a common dermatological complaint produced by disruption of the normal wound healing process. Several treatment modalities for keloids are available with variable degrees of response such as surgical excision, topical and intralesional corticosteroids, interferon, botulinum toxin, cryotherapy and laser therapy. Aim of the Study The aim of the present study is to compare the clinical efficacy and safety of intralesional botulinum toxin type A and cryotherapy in the treatment of keloids. Patients and Methods This study included 10 patients complaining of keloids (at least 2 lesions). Keloids were treated by either cryotherapy (one session every two weeks) or intralesional BTX-A (5 IU/cm2 once every 4 weeks). Punch biopsy was done for every lesion before the start of treatment and repeated 4 weeks after the end of treatment. Results Both treatment modalities achieved statistically significant clinical response (keloid pliability, height and VSS score) histological response (epidermal thickness) and immunohistochemical response (fibronectin spot count). Both treatments were well tolerated and satisfying to included patients.