Comparative Results in Treatment of Keloids With Intralesional 5-FU/Kenalog, 5-FU/Verapamil, Enalapril Alone,Verapamil Alone, and Laser: A Case Report and Review of the Literature

• Published in: Journal of drugs in dermatology Vol. 15; no. 11; p. 1442
• Main Authors: Alexandrescu, Doru, Fabi, Sabrina, Yeh, Lindsey C, Fitzpatrick, Richard E, Goldman, Mitchel P
• Format: Journal Article
• Language: English
• Published: United States 01.11.2016
• Subjects: Adult; Drug Therapy, Combination; Enalapril - administration & dosage; Fluorouracil - administration & dosage; Humans; Injections, Intralesional; Keloid - diagnosis; Keloid - therapy; Laser Therapy; Male; Treatment Outcome; Triamcinolone Acetonide - administration & dosage; Verapamil - administration & dosage
• ISSN: 1545-9616

The pathogenesis of keloids involves a hyperproliferative state due to molecular abnormalities, cellular driving pathways, such as TGF, VEGF, and the inactivation of proapoptotic genes. We reviewed the literature and compared various treatment combina- tions in the treatment of keloids in a one patient observation. Treatment modalities consisted of: intralesional 5- uorouracil (5-FU)/triamcinolone (TMC), 5-FU/verapamil, enal- april alone, verapamil alone, and fractional carbon dioxide laser. Size, height, and softness of the keloid, pain, itching, and pain were assessed. 5-FU based treatments proved to be more ef cacious than the other modalities. 5-FU + TMC demonstrated the largest reduc- tion in keloid height and rmness. The greatest degree of scar softening and average size reduction was achieved with 5-FU/ TMC (80% and 70% reduction, respectively), followed by 5-FU/verapamil (50% and 33% reduction, respectively). The same combinations led to the greatest reduction in scar height (70% and 33%, respectively). All treatments led to resolution of pain and itching in the keloid. The favorable effects of the 5-FU + verapamil combination are new and deserve further exploration. J Drugs Dermatol. 2016;15(11):1442-1447..