Intralesional corticosteroid injection versus ablative fractional laser associated with corticosteroid drug delivery in the treatment of keloids: a comparative study

INTRODUCTION: Keloids are known to impact the quality of life of their patients. Intralesional corticosteroid injection (ICI) is still the most widely used therapeutic option, although with variable results and limitations. Numerous other strategies have been studied, including the association of lasers with drug delivery (DD).
OBJECTIVES: To compare the therapeutic response between ICI with isolated triamcinolone acetonide and the association of ablative fractional laser (AFL) and DD of the same drug, and assess quality of life.
METHODS: We followed-up eight keloid patients who underwent three sessions with a one-month interval between them. ICI was performed in the right half of the scar and AFL and DD on the left. In assessing the results studied statistically, we used measurement and clinical and photographic comparison of the lesions, the Vancouver clinical and analog pain scales, and the Dermatology Life Quality Index questionnaire.
RESULTS: We observed a statistically significant improvement in keloids with both techniques. In comparison, ICI was significantly higher than the AFL with DD. On the other hand, the latter technique was statistically less painful. As for patients' quality of life, a significant improvement was observed after treatment in both cases.
CONCLUSIONS: Both methods were significantly effective in improving keloids; however, ICI showed to be superior. AFL with DD was better tolerated than ICI and is an interesting option for patients with extensive lesions or low pain tolerance.

Keywords: Drug delivery systems; Injections, Intralesional; Keloid; Lasers; Triamcinolone acetonide