Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids

Ahuja, Rajeev; Chatterjee, Pallab

doi:10.1016/j.burns.2013.09.029

Cited by 96 publications

(136 citation statements)

References 23 publications

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“…23 In the present study following intralesional TAC 20, a majority (62.79%) of patients of keloids showed significant mean reduction in VSS. The observations were in conformity with that of Uzair et al 19 The improvement observed was comparable to TAC 40mg/ml used by Chatterjee A and Shanthi M et al 15,20 The improvement in keloid with TAC 20 mg/ml was observed to be similar to TAC 40mg/ml used in other studies. 15,19,20,23,24 Immediate pain at the site of injection was the commonest side effect with TAC 20 as reported by 84% of the subjects.…”

Section: Resultssupporting

confidence: 90%

“…The observations were in conformity with that of Uzair et al 19 The improvement observed was comparable to TAC 40mg/ml used by Chatterjee A and Shanthi M et al 15,20 The improvement in keloid with TAC 20 mg/ml was observed to be similar to TAC 40mg/ml used in other studies. 15,19,20,23,24 Immediate pain at the site of injection was the commonest side effect with TAC 20 as reported by 84% of the subjects. However, the pain was mild, transitory and resolved within few hours, which is attributed to dilution with lignocaine and adrenaline which causes a sustained hypoesthesia and therapeutic effect at the site, locally.…”

Section: Resultssupporting

confidence: 90%

“…Uzair et al and Ahuja et al also observed predominance of keloid in the younger age group. 19,20 The duration of keloids in majority of subjects was less than 12 months. The majority showed a very good to excellent response conforming observations from studies.…”

Section: Resultsmentioning

confidence: 99%

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The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

Garg

Shah

Garg³

et al. 2018

Int Surg J

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Background: Management of keloid is difficult as well as challenging. Intralesional triamcinolone acetonide (TAC) injections have remained a gold standard in non-surgical management of keloid. TAC is generally used in the concentration of 40mg/ml, which causes adverse effects such as local dermal atrophy and hypopigmentation. Aim was to study efficacy and adverse effects of TAC in treatment of keloid, in a lesser concentration of 20mg/ml.Methods: An open label study was conducted from November 2015 to May 2017 on 25 subjects of either gender, in the age group 11-55 years, at a medical college hospital. Intralesional injection TAC 20 was administered in the keloid at an interval of 3 weeks, for a total of 6 sessions, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement and SPSS 21 for statistical analysis.Results: Mean age of keloid subjects was 30.72 years and median duration of keloid was 8 months. The mean VSS score before treatment was 8.36 which reduced to 3.20 after treatment. Mean percentage change in VSS score was 62.79%, which was very highly significant (p <0.001). Physician’s assessment was ‘Very Good’ in 52.0% and ‘Excellent’ in 5 (20%). Adverse effect of atrophy was seen in 3 (12%), hypopigmentation in 11 (44%) and telangiectasia in 4 (16%).Conclusions: Intralesional injection triamcinolone acetonide 20mg/ml gives very good to excellent improvement in the majority of patients of keloid. Local adverse effects seen were hypopigmentation, atrophy and telengiectasia.

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Section: Resultssupporting

confidence: 90%

Section: Resultssupporting

confidence: 90%

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The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

Garg

Shah

Garg³

et al. 2018

Int Surg J

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“…Similarly, Lawrence used intralesional verapamil hydrochloride after earlobe surgical keloid excision revealed a 52% cure rate in 35 AfricanAmerican patients. 14 Ahuja et al 15 compared the effect of Triamcinolone and verapamil injections for treatment of keloid concluding that verapamil is the best choice for flattening the raised scars; our results 62 (53.91%) also speeks of that mixture of Triamcinolone and 5 florouracil is as good as verapamil for hypertrophic scar flattening. Our study shows that intraleisional therapies using mixtures in keloid lesions have superiority over single agent therapy preferably with intralesional injection of regard, triamcinolone and 5 florouracil have lesser reactions and more effective than triamcinolone alone which have slightly slower effect.…”

Section: Resultssupporting

confidence: 51%

Keloids and Hypertrophic Sacrs; Comparison of Intraleisional Injection of Triamcinolone Alone and Triamcinolone Mixed With 5 Flourouracil in Treatment of Keloids and Hypertrophic Scars

Butt

Latif

Khan

et al. 2017

TPMJ

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ABSTRACT… Objectives:To compare the effectiveness of triamcinolone alone and triamcinolone mixed with 5-flourouracil used for intralesional injection to treat symptomatic hypertrophic scars and keloids. Study Design: Prospective study. Place & duration of study: Departments of Plastic and General Surgery, Khawaja Muhammad Safdar Medical College, Sialkot from January 2014 to September 2016. Material and Methods: Plastic and general surgery outpatients with symptomatic keloids and hypertrophic scars fulfilling inclusion criteria were registered. Adult patients irrespective of gender, areas involved and size of the keloids were included. Patients refusing treatment, pregnant and lactating women were excluded; similarly the patients not completing the follow up for at least 3 months were dropped from the statistical analysis. Patients' response to treatment was judged by the reduction in the physical size of keloids and subjective improvement in symptoms of itching, discomfort, pain, deformity or redness. Minimum of three sessions of treatment was must for assessment of outcome. Data was entered and analysis done by SPSS v 22. Results: Of the 293 outpatients 115 were treated by the mixed triamcinolone and 5 flourouracil while 178 patients were injected with triamcinolone only. Female patients were more in number with ratio of 2.8:1. Good response to treatment with Triamcinolone alone was obtained in 69 (38.76%) while good response was seen in 62 (53.91%) of patients with intralesional Triamcinolone mixed with 5-flourouracil. Conclusion:The intra-lesional steroid injection commonly used as its treatment has convincing response. The presently used mixture of steroids and 5-flourouracil has more promising results as regards patients' improvement in symptomatology as well as physical reduction in the size. Key words:5-fluorouracil, Triamcinolone, Intraleisional, Keloids, Hypertrophic scar.

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“…As in any injection in connective tissue, the patient may experience pain at the injection site and recurrence in variable rates (less than 50% of cases). It is important to mention that other therapeutic options such as interferon, bleomycin, 5-FU and steroids have shown higher incidence of adverse effects [21,22] (Table 1).…”

Section: Verapamil As a Therapeutic Alternativementioning

confidence: 99%

Verapamil as Alternative Treatment in Hypertrophic and Keloid Scars

Ramos-Gallardo¹,

Delgado-Hernández²,

Cervantes-López³

et al. 2017

J Pigment Disord

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Hypertrophic and keloid scars represent one of the main aesthetic and functional defects in patients after trauma, surgery, or burn. There are different therapeutic approaches used for these conditions, each showing varied results. Verapamil is a selective L-type calcium channel antagonist, which is currently considered as an alternative treatment in hypertrophic and keloid scars. Verapamil reduces the production of extracellular matrix, enhances collagenase secretion, and inhibits Interleukin 6 (IL-6), vascular endothelial growth factor (VEGF) and fibroblast cell proliferation. It also reduces the expression of transforming growth factor beta 1 (TGF-β1), subsequently inducing apoptosis. Verapamil is hereby proposed as an alternative and effective therapy for hypertrophic and keloid scars.

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Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids

Cited by 96 publications

References 23 publications

The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

Keloids and Hypertrophic Sacrs; Comparison of Intraleisional Injection of Triamcinolone Alone and Triamcinolone Mixed With 5 Flourouracil in Treatment of Keloids and Hypertrophic Scars

Verapamil as Alternative Treatment in Hypertrophic and Keloid Scars

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