Determination of the optimal frequency of injection of triamcinolone: monitoring change in volume of keloid lesions following injection of 40 mg of triamcinolone

Aluko-Olokun, Bayo; Olaitan, Ademola Abayomi; Ladeinde, Akinola Ladipo; Aluko-Olokun, Oluseun A.; Alade, Morenike Olubunmi; Ibukun-Obaro, Oluwaseyi; Adenaike, Funmilola Seun

doi:10.1007/s00238-015-1139-5

Cited by 7 publications

(1 citation statement)

References 13 publications

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“…Volume reduction was found to be most profound within the first 2 weeks post-injection. This was not significant anymore between 3 and 4 weeks, and a reversal trend was identified after 4 weeks (p ≤ 0.05) [54]. In line with this study, the mostly (79%) used treatment interval among RCTs in our study is 3-4 weeks.…”

Section: Incomplete Reportingsupporting

confidence: 81%

Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

et al. 2023

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Background Intralesional corticosteroid administration (ICA) is a first-line treatment for keloids. However, its clinical results are still highly variable and often suboptimal. Treatment results may strongly be influenced by various operator dependent factors. The aim of this study is to map the details of ICA in keloids described in randomized controlled trials (RCTs), hence presenting the scientific practice of a first-line treatment for keloids in the best available evidence. Summary A systematic search was performed on PubMed, Ovid MEDLINE, Ovid EMBASE and CENTRAL. Eligible studies were RCTs including patients with keloids treated with intralesional corticosteroids. Treatment and study design related data were charted on a predefined form. Thirty-eight RCTs were included for data extraction. Triamcinolone acetonide was used in 37 (97.4%) studies. Dosing per cm2 could only be compared among ten (26%) studies, and varied from 1 to 20 mg. The maximum dose per session varied from 20 to 80 mg. Anesthetics were administered locally and orally in seven and one RCT(s). Treatment intervals varied from weekly to monthly, with four weeks most frequently (50%) used. Needle size was reported in eleven (29%) studies and varied from 26 to 30-gauge. Syringe size was specified in four (11%) studies, being 1 mL. The injection level was described in eleven (29%) studies. Blanching as endpoint was reported in ten (26%) studies. Outcome measures varied widely, from height, surface area or volume, to Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, pain and itch scores, patient satisfaction and different efficacy rates. Only six studies had a follow-up of ≥6 months. Recurrence was identified in two studies with 18 weeks and 1 year of follow-up. Adverse events were reported in 25 (66%) studies. Key messages There is incomplete reporting and substantial heterogeneity in many aspects of ICA and study design among RCTs. This scoping review underscores the urgent need for standardization of treatment protocol and study design to enhance and uniform research conduct among keloid studies.

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Section: Incomplete Reportingsupporting

confidence: 81%

Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

et al. 2023

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Modified Island Technique for Prominent Ears

Mayer

Loustau

2017

Aesth Plast Surg

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There have been several methods described for the correction of prominent ears, including techniques that excise, bend, suture, score, or cut the auricular cartilage. The Island Technique, proposed by Pitanguy, is based on the creation of a cartilage island to define the antihelix and correct the conchoscaphal angle. Visibility of sharp edges has been the main criticism of this technique. To avoid them, we advise performing an internal bevel incision to round off the edges and achieve a more natural look. Also, sometimes prominent ears are asymmetric with different conchoscaphal angles, determining a residual but protruding upper pole, thus requiring different treatment on each side. For such cases, we propose the additional excision of a cartilage strip from the lower border of the auricular scapha, with a greater conchoscaphal angle. In this way, cartilage islands of similar width and identical antihelixes for both ears are created and a symmetric result is achieved. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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KECORT Study: An International e-Delphi Study on the Treatment of KEloids Using Intralesional CORTicosteroids in Clinical Practice

Yin,

Wolkerstorfer,

Lapid

et al. 2024

Am J Clin Dermatol

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Background Intralesional corticosteroid administration (ICA) is a first-line keloid treatment. However, it faces significant variability in current clinical and scientific practice, which hinders comparability of treatment results. Objectives The aim of the study was to reach consensus on different aspects of ICA using hypodermic needles in keloids among an international group of dermatologists and plastic surgeons specialized in keloid treatment to provide consensus-based clinical treatment recommendations for all physicians treating keloids. Methods The keloid expert panel of 12 dermatologists and 11 plastic surgeons rated 30 statements. Two online e-Delphi rounds were held, both with a response rate of 100%. Fifteen (65%) keloid experts participated in the final consensus meetings. Consensus was defined as ≥ 75% of the participants choosing agree or strongly agree on a 7-point Likert scale. Results Consensus was reached on treatment goals, indication for ICA, triamcinolone acetonide (TAC) 40 mg/mL as the preferred corticosteroid administered at a maximum of 80 mg per month and at intervals of 4 weeks, minimizing pain during ICA, the use of 1 mL syringes and 25 or 27 Gauge needles, blanching as endpoint of successful infiltration, caution of not injecting subcutaneously, and the option of making multiple passes in very firm keloids prior to infiltration. Consensus could not be reached on TAC dosing, methods of prior local anesthesia, and location of injection. Conclusions This e-Delphi study provides important clinical treatment recommendations on essential aspects of ICA in keloids. By implementing these recommendations, uniformity of ICA in keloid treatment will increase and better treatment results may be achieved. Supplementary Information The online version contains supplementary material available at 10.1007/s40257-024-00888-7.

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Determination of the optimal frequency of injection of triamcinolone: monitoring change in volume of keloid lesions following injection of 40 mg of triamcinolone

Cited by 7 publications

References 13 publications

Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

Intralesional Corticosteroid Administration in the Treatment of Keloids: A Scoping Review on Injection Methods

Modified Island Technique for Prominent Ears

KECORT Study: An International e-Delphi Study on the Treatment of KEloids Using Intralesional CORTicosteroids in Clinical Practice

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