A Comparative Study of Efficacy of Intralesio...

A Comparative Study of Efficacy of Intralesional Triamcinolone Acetonide alone and in Combination with 5-Fluorouracil in the Treatment of Periorbital Hypertrophic Scars

Author Name : Urmil Chawla, Khushboo Sheoran, Akanksha Rani, Neebha Passi, Reena Gupta, Tejal Bidhalan, Deepshikha Yadav

ABSTRACT

Purpose: To compare the efficacy of intralesional triamcinolone acetonide (TAC) alone and in combination with 5-Fluorouracil (5-FU) in the treatment of periorbital hypertrophic scars.

Methodology: It was a prospective, interventional, single centre study conducted over a period of 2 years (Jan 2020 to Dec 2021). Group I (n=10) was treated with intralesional TAC 40mg/ml (Steroid group) and Group II (n=10) with intralesional TAC (40mg/ml) + 5-FU (50mg/ml) in a ratio of 1:9 (Combination group). Scar assessment was done by Modified Vancouver Scar Assessment Scale. Injections were repeated every two weeks (maximum four) depending on the response. Evaluation was done before every injection and finally at 1 and 3 months post last injection.

Results: Both the groups had comparable baseline parameters. Both the groups showed statistically significant reduction in Anatomical Assessment Score (AAS), in Group I, 8 patients (80%) had mild and 2 (20%) had moderate improvement. In Group II, 2 (20%) had mild and 8 (80%) had moderate improvement (p value 0.007), the results were significantly better in Group II. There was no statistically significant difference in the 2 groups in terms of symptomatic and functional assessment score. Redness and swelling were two major complications observed, with no statistically significant difference between the two groups. Similar results were seen for the parameter of photograph assessment score.

Conclusion: Both TAC and TAC + 5FU injections are effective in periorbital hypertrophic scar modulation. However, the combination was found to be significantly better in improving Anatomical Assessment Score with lesser adverse effects.

Key words: Hypertrophic scars, triamcinolone acetonide, 5-Fluorouracil