Experience Treating Earlobe Keloids with Laser Diode 980nm Excision Followed by Triamcinolone Infiltration

Abstract

Background and Objective Lasers have a favorable synergistic effect when combined with other modalities of treatment against keloids. Different types of lasers have been used with triamcinolone infiltration, resulting in promising success rates. The purpose of this study is to describe our first experience treating earlobe keloids with 980 nm laser diode excision followed by triamcinolone infiltration and present our outcomes after 24 months of follow‐up. Study Design/Materials and Methods A retrospective chart review of 11 patients with 14 earlobe keloids treated with excision using a 980 nm laser diode followed by triamcinolone acetonide infiltration, between January 2015 and May 2016. Database included demographics, Fitzpatrick skin type, laterality, lesion size, and postoperative visits information. Outcomes were assessed in terms of keloid recurrence rates, complications, and patient subjective aesthetical result satisfaction after 24 months of follow‐up. Results All procedures were technically completed, and follow‐up accomplished without attrition. One (7.14%) patient experienced keloid recurrence after the third month. Four (28.57%) patients experienced early wound dehiscence, successfully treated with debridement and re‐suture. Self‐assessment of aesthetical result was considered “very good” in 64.28% of patients. Conclusion Surgical excision with 980 nm laser diode followed by triamcinolone infiltration is well‐tolerated and shows favorable results treating earlobe keloids, and can be considered a first‐line treatment. Comparison between different types of lasers and control groups in large clinical trials is warranted in order to obtain strong clinical evidence for clear indications and recommendations. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

A new combined surgical and medical technique for auricular keloids

“…However, when used in monotherapy, laser therapy shows recurrence rates similar to conventional surgery alone (45%-100%). 5 We present a new technique for recalcitrant auricular keloids, which combines surgery, contact cryotherapy, intralesional injections of 5-FU, and TA.…”

Comparison of surgical excision followed by adjuvant radiotherapy and laser combined with steroids for the treatment of keloids: A systematic review and meta‐analysis

“…14 with recurrence rates paralleling those of traditional surgical excision alone, ranging from 45% to 100%. 15 The combination of various laser types with other treatment methods, including triamcinolone acetonide (TA), has led to encouraging success rates. Recent research has suggested that the combination of intralesional steroids with laser treatment enhanced efficacy and reduced recurrence rate.…”

“…Recent research has suggested that the combination of intralesional steroids with laser treatment enhanced efficacy and reduced recurrence rate. 15 , 16 …”

“…Recent research has suggested that the combination of intralesional steroids with laser treatment enhanced efficacy and reduced recurrence rate. 15,16 Although multiple studies have reported the efficacy and safety of combined surgical excision with adjuvant radiotherapy and laser plus intralesional steroids in the treatment of keloids, the results vary across studies. Moreover, there is currently a lack of meta-analysis comparing the treatment outcomes of these two combination therapies for keloids.…”

“…However, when used independently, lasers have demonstrated limited efficacy in keloid management 14 . with recurrence rates paralleling those of traditional surgical excision alone, ranging from 45% to 100% 15 . The combination of various laser types with other treatment methods, including triamcinolone acetonide (TA), has led to encouraging success rates.…”