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Potentials for implementing pressure‐controlled jet injection in management of keloids with intralesional 5FU and corticosteroids
Author(s) -
Levenberg Alex,
Vinshtok Yuri,
Artzi Ofir
Publication year - 2020
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.13522
Subject(s) - medicine , tolerability , triamcinolone acetonide , keloid , adverse effect , visual analogue scale , corticosteroid , surgery , lesion , anesthesia
Background Needle‐free jet injection implements kinetic energy of liquid jet for transcutaneous delivery of drugs into soft tissues. Combination therapy of intralesional 5‐fluorouracil and triamcinolone offers efficacious treatment for keloids with a reduced adverse effect of the drug monotherapy. This study evaluates safety and efficacy of the drug combination administered to keloid scars via intralesional jet injections. Methods A retrospective analysis of the keloid treatments was performed. Efficacy was assessed by reviewing pre‐ and post‐treatment scores of the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) and by comparing baseline and photographs taken 3 months after the treatments. Safety and tolerability were collected and analyzed. Results Twenty‐one subjects (M/F = 11/10) with 39 keloids received the treatments. Treatments were well‐tolerated by all patients at mean injection pain of 2.0 ± 1.0 per Numeric Pain Rating Scale (NPRS). Self‐resolved lesion ulceration was observed in 4 patients. Post‐treatment evaluation demonstrated a 53% decrease in total VSS score ( P < 0.05) and in all sub‐categories. Mean patient score of POSAS decreased in the color, stiffness, thickness, and irregularity components. Pain and pruritus lessened by 69% and 79% ( P < 0.05 in both), respectively, among the patients with complaints prior to the treatment. Independent reviewers reported an average 51%‐75% reduction in keloids. Conclusions Improved appearance of keloids and symptomatic relief was achieved by intralesional administration of combined 5‐fluorouracil and corticosteroid through the high‐pressure jet injections. The synergy between the drug combination and the jet physical impact provided clinical effect.