The Clinical Efficacy Observation On Injection Of Corticosteroid On The Treatment Of Keloids

Objective: To observe the clinical efficacy and side effects of triamcinolone acetonide and diprospan in the treatment of keloid.Methods: 46 patients with keloid were enrolled in this study.They were aged between 21 and 52 years(average 31.9 years),including 19 males and 27 females.All patients were randomized to the diprospan group and triamcinolone acetonide group,with 23 patients in each group.Triamcinolone acetonide injection(Shanghai Xudong Haipu Pharmaceutical Co.,Ltd.,National Medicine Permission Number H20063226,specifications 5mL: 50mg)and 2% lidocaine injection was mixed in 1: 1 volume ratio,with sterile syringe for intralesional injection.Performed 3-5 times treatment,each time interval of 2 to 3 weeks.Compound betamethasone injection [MSD Merck Sharp &Dohme AG(Switzerland),National Medicine Permission Number J20140160,Specification 1mL: betamethasone dipropionate(betamethasone)5mg and betamethasone sodium phosphate(betamethasone)2mg] and 2% lidocaine injection was mixed in 1: 1 volume ratio,with sterile syringe for intralesional injection.Performed3-5 times treatment,each time interval of 3 to 4 weeks.The images of skin lesions were collected by Antera 3D camera before each time treatment.The image analysis system was used to analyze the appearance,volume and color of keloid.With the follow-up after treatment,we assess the efficacy and adverse reactions.Results: 46 patients with 57 keloids,after the completion of 1,2,3,4 and 5 timestreatment the total effective rate of keloid volume improvement in the diprospan treatment group respectively(3/30)10%,(7/30)23.3%,(12/30)40%,(19/30)63.3%,(23/30)76.7%.The total effective rate of keloid volume in the triamcinolone acetonide treatment group respectively(4/27)14.8%,(7/27)25.9%,(11/27)40.7%,(13/27)48.1%,(22 /27)81.5%.With the increase in the number of treatment,the clinical total effective rate of each group was on the rise.After 5 times treatment,the total effective rate in the triamcinolone acetonide group(81.5%)was slightly higher than diprospan group(76.7%)(P>0.05).After the completion of 1,2,3,4 and 5 times treatment,the ratio of patients with pain score below 3 points in the diprospan treatment group respectively(6/23)26.1%,(8/23)34.8%,(12/23)52.2%,(17/23)73.9%,(18/23)78.3%.The ratio of patients with pain score below 3 points in the triamcinolone acetonide treatment group respectively(7/23)30.4%,(8/23)34.8%,(14/23)60.9%,(15/23)65.2%,(17/23)73.9%.With the increase in the number of treatment,the ratio of patients with pain score below3 points in each group was on the rise.After 5 times treatment,the ratio of patients with pain score below 3 points in the diprospan group(78.3%)was higher than triamcinolone acetonide group(73.9%)(P>0.05).After the completion of 1,2,3,4 and 5 times treatment,the percentage of patients with no itching and mild itching in diprospan treatment group respectively(7/23)30.4%,(11/23)47.8%,(16/23)69.6%,(17/23)73.9%,(19/23)82.6%.The percentage of patients with no itching and mild itching in triamcinolone acetonide treatment group respectively(8/23)34.8%,(11/23)47.8%,(14/23)60.9%,(16/23)69.6%,(20/23)87%.With the increase in the number of treatment,the rate of patients with no itching and mild itching in the two groups were on the rise.After 5 times treatment,the rate of patients with no itching and mild itching in the triamcinolone acetonide group(87%)was higher than diprospan group(82.6%)(P>0.05).After 5 times treatment,the incidence of adverse reactions in diprospan group(8.7%)was significantly lower than triamcinolone acetonide group(39.1%)(P <0.05).Conclusion: Diprospan and triamcinolone acetonide have good clinical curative effect in the treatment of keloid,and the total effective rate increases with the increase of the number of treatments.Symptoms of pain and itching were further alleviated withthe number of treatments increases.For the improvement of keloid volume and the relief of itching and pain,triamcinolone acetonide and diprospan had similar efficacy,the difference was not statistically significant.The incidence of adverse reactions in diprospan group was significantly lower than that in triamcinolone acetonide group,the difference was statistically significant.The use of diprospan in the treatment of keloid is worthy of clinical application.