KẾT QUẢ ĐIỀU TRỊ SẸO LỒI BẰNG TIÊM NỘI TỔN THƯƠNG TRIAMCINOLON ACETONID KẾT HỢP 5 - FU

Abstract

Background: Keloids are benign fibroproliferative lesions that often progress continuously and may cause pruritus or pain. Triamcinolone acetonide is the mainstay of treatment but is associated with multiple adverse effects. This study aimed to compare the therapeutic outcomes of intralesional injections of triamcinolone acetonide combined with 5-fluorouracil (5-FU) versus triamcinolone acetonide alone in the treatment of keloids. Subjects and Methods: A total of 33 patients with 90 keloids located on the chest were randomly assigned to two treatment groups. Group 1 consisted of 20 patients (45 keloids) receiving intralesional injections of triamcinolone acetonide combined with 5-FU at a 1:9 ratio. Group 2 included 13 patients (45 keloids) receiving intralesional injections of triamcinolone acetonide combined with 0.9% sodium chloride at a 1:9 ratio. Injections were administered weekly for up to 12 weeks or until complete flattening of the keloid. Results: At week 4^th, the mean percentage improvement in thickness in Group 1 was 75.25 ± 22.97%, significantly higher than Group 2 (48.39 ± 33.15%; p < 0.001). The mean percentage improvement in firmness was 75.41 ± 23.81% in Group 1 versus 58.33 ± 34.45% in Group 2 (p = 0.008). The mean percentage improvement in redness was 91.89 ± 30.81% in Group 1 compared to 47.99 ± 31.49% in Group 2 (p < 0.001). At week 8, the mean percentage improvement in thickness was 89.05 ± 11.53% in Group 1 versus 74.50 ± 24.80% in Group 2 (p = 0.012). The mean percentage improvement in firmness was 89.42 ± 12.59% in Group 1 versus 76.75 ± 27.01% in Group 2 (p = 0.041). The mean percentage improvement in redness was 99.23 ± 3.92% in Group 1 versus 70.01 ± 36.26% in Group 2 (p < 0.001). Symptom improvement rates for pruritus were 100% in Group 1 and 91.6% in Group 2 (p > 0.05), while pain improvement rates were 100% and 83.3%, respectively (p > 0.05). The main adverse effect in Group 1 was hyperpigmentation (86.7%), along with self-limited scaling or erosion in 22.2% of cases. In Group 2, hyperpigmentation occurred in 22.2% of cases. Conclusions: Intralesional injection of triamcinolone acetonide combined with 5-FU is a safe and more effective treatment for keloids compared with triamcinolone acetonide alone.