Comparative study of safety and efficacy of cryotherapy followed by intralesional corticosteroid injection versus intralesional injection of corticosteroid plus 5- flurouracil in the treatment of keloid

Background: Keloid is an overgrowth of dense, fibrous tissue, usually developing after healing of a skin injury and extends beyond the borders of the original wound. The treatment of keloid has been a challenge, and at times, frustrating because of the recurrence. Objective: To compare the safety and efficacy of cryotherapy followed by intralesional corticosteroid injection versus intralesional injection of corticosteroid plus 5- flurouracil in the treatment of keloid. Materials and methods: The Department of Dermatology & Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka conducted a cross-sectional comparative study on 70 outpatients with clinically diagnosed keloids. SPSS 23 was used to analyses data. The significance threshold of p < 0.05 was analyzed using the chi-square test and student “t” test. Mean standard deviation was used for continuous scale data and number percentage for categorical data. Results: TAverage age was found 33.5±9.3 years in group A, 31.7±10.3 in group B. Scar height was 3.47±0.99 mm in group A and 3.59±0.61 mm in group B. At the first follow-up, scar height was significantly larger in group A (2.54±0.87 vs 2.12±0.54 mm) than group B. At 2nd follow-up, scar height was considerably greater in group A (1.85±1.01 vs 1.10±0.43 mm) than group B Group A had 17 (48.6%) efficacy and group B 26 (74.3The end outcome was good to excellent for 16 (45.7%) in group A and 25 (71.4%) in group B. The two groups showed a significant difference (p<0.05). Side effects included 6 (17.1%) skin atrophy in group A but none in B. Telangiectasia was 8(22.9%) in group A and 1(2.9%) in B. Hypopigmentation was 7(20.0%) in group A and absent in B. Ulceration was 47 (11.4%) in group B but not in A. Group A had 14 (40.0%) recurrence and group B 6 (17.1%). The two groups showed a significant difference (p<0.05). Conclusion: Cryotherapy followed by intralesional corticosteroid with 5-fluorouracil treating keloids is more effective, lasts less, and has less side effects than Cryotherapy alone. Cryotherapy followed by intralesional corticosteroid plus 5-fluorouracil reduces scar height considerably.