A comparative study of the efficacy of intralesional 5 fluorouracil vs combination of 5 fluorouracil with triamcinolone acetonide in keloids

Context: Keloids are defined as scars that invade the adjacent tissues and rarely regress. In recent years, antimitotic drugs have been used in the management of keloids with promising results. This study highlights the effectiveness of 5-fluorouracil (5-FU) in keloids. Aims: To study the efficacy of intralesional 5-FU in keloids as a solo agent and in combination with triamcinolone acetonide and to study the side effects of both the drugs. Methods and Materials: A total of 30 patients with keloids were randomly allocated into two groups. Group A received 50 mg/mL of 5-FU intralesionally. Group B patients received a combination of 40 mg/mL of intralesional triamcinolone acetonide and 50 mg/mL of 5-FU. The patients were observed for immediate and delayed complications and the treatment was continued for a total of 3 months. Statistical Analysis Used: ANOVA, Mann–Whitney test, Fisher's test, Chi-square test. Results: The patients in both groups showed a significant reduction in the size and thickness of the lesions. The reduction in the length of keloid was highly significant in both the groups but in comparison, there was no statistically significant difference in the reduction of lesions among both the groups. Hence, both modalities of treatment can be claimed to be equally efficacious. The therapeutic response was good to excellent in most patients with only one patient opting out of the therapy in the 5-FU group due to the inability to tolerate the pain. The common side effects noted were pain, itching, ulceration, burning sensation, and bulla formation. Conclusions: 5-FU, both as a single agent or in combination with steroids is equally efficacious in reducing the keloid size. The side effects are lesser with the combination group.