Fractional carbon dioxide (CO₂) laser alone versus fractional CO₂ laser combined with triamcinolone acetonide or tricholoroacetic acid in keloid treatment: A comparative clinical & radiological study
Citation: El-Azhary EA, Abd Al-Salam FM, Hafiz HSA, Maghraby HM. Fractional carbon dioxide (co₂) laser alone versus fractional co₂ laser combined with triamcinolone acetonide or tricholoroacetic acid in keloid treatment: a comparative clinical and radiological study. Dermatol Pract Concept. 2022;12(2):e2022072. DOI: https://doi.org/10.5826/dpc.1202a72
Accepted: October 11, 2021; Published: April 2022
Copyright: ©2022 El-Azhary et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication
Corresponding author: Engy Abd El-Hamid Abd El-Hamid El-Azhary, MBBCh, General Medicine and Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt. E-mail: email@example.com
Introduction: Keloids are benign fibro-proliferative scarring extending outside the initial wound. Different modalities of treatment as intralesional corticosteroid injection, fractional CO₂ laser and others can be used either as mono or combined therapies.
Objectives: To assess the role of fractional CO2 laser versus fractional CO2 laser accompanied with either triamcinolone acetonide or trichloroacetic acid 20% in keloid treatment clinically and radiologically.
Methods: The current study was conducted on 45 Egyptian participants with keloid scar at different sites of the body. They were classified into three groups treated by fractional CO2 laser only (group I), fractional CO2 laser followed by triamcinolone acetonide (group II) or trichloroacetic acid application (group III) respectively. Evaluation of the keloid was done with Vancouver Scar Scale (VSS) and Color Doppler Ultrasound (CDU) before and after treatment. Four sessions, one month apart were applied for the patients. They were followed up for 8 weeks after the last session.
Results: After treatment, there was high statistically significant reduction in Vancouver Scar Scale among the three groups (P value ≤ 0.001), reduction was more in group II then I then III. Also, high statistically significant reduction in keloid scar thickness assessed by Doppler was recorded (P value ≤0.001 in group II and P value ≤0.01 in group I & III).
Conclusions: Combined therapy is favorable in treatment of keloids. Trichloroacetic acid is a promising modality in treating keloid; hence it can be tried in different combinations. Color Doppler Ultrasound is a promising method of keloids pre- and post-treatment assessment.