Concurrent Multi-Modality Treatment of Keloids (CMTK) Not Manageable by Conventional Postoperative Radiotherapy

Abstract

<p class="MsoNormal"> <span lang="EN-US" style="font-family:Verdana;">Objective: To design and test a treatment regimen which is clinically responsive, readily available, cost effective, and applicable especially to children and women of child bearing age.</span><span lang="EN-US"> </span><span lang="EN-US" style="font-family:Verdana;">Design Setting: A prospective cohort study.</span><span lang="EN-US"> </span><span lang="EN-US" style="font-family:Verdana;">Setting: Two major postgraduate teaching hospitals: one in Tripoli, Libya and the other in Jeddah, Saudi Arabia.</span><span lang="EN-US"> </span><span lang="EN-US" style="font-family:Verdana;">Participants: Fifty-seven patients with 79 keloids, referred from Plastic Surgery Units between April 1996 and January 2005.</span><span lang="EN-US"> </span><span lang="EN-US" style="font-family:Verdana;">Main Outcome Measure: Degree of flattening of the keloidal lesion and symptomatic recovery.</span><span lang="EN-US"> </span><span lang="EN-US" style="font-family:Verdana;">Results: Result of treatment has been analyzed using unified set criteria. Seventy-seven percent of this cohort had complete response. 19% of cases had partial response, 50% acknowledged the treatment outcome had been “satisfactory” and 44% had an “acceptable” outcome. There was no significant acute or delayed reaction.</span><span lang="EN-US"> </span><span lang="EN-US" style="font-family:Verdana;">Conclusion: The technique appears universally adaptable, cost effective, and can safely be prescribed for children and women of child-bearing age. In spite of prolonged treat</span><span lang="EN-US" style="font-family:Verdana;">ment course, compliance was excellent.</span><span lang="EN-US"><o:p></o:p></span> </p

A Case of Post Varicella Recurrent Presternal Butterfly Keloid

“…This lesion is a clinical challenge having several poor prognostic indicators and little documented record reporting management of such a lesion. Using combinations of concurrent multi-modality treatment, Malaker et al [8] in a series of 71 cases of recurrent or "difficult to treat keloids" reported some success. But in their series of 71 cases, 5 presternal butterfly keloids, none had multiple poor prognostic indicators like thiscase.…”

“…They injected the entire lesion with combination of triamcinolone, dexamethasone and hyaluronidase, weekly for 6 -8 weeks. Immediately after the injection the lesions were covered with silicone gel sheets and compressed with 1.5 -2 cm thick hard bee wax blocks customized to the shape of the keloid, and compressed and retained with elastoplast bandage, for one week and repeat the procedure weekly [9][10][11]. It is cheap and suitable for, children, adolescence and women.…”