Evaluating the efficacy of intralesional verapamil over intralesional triamcinolone in management of keloid: an evidence based case report

Author present a case of 22-year-old female with keloid due to previous trauma three years prior. Keloids are excessive fibroblast growth present in pathological scars. Therapy for keloids still remain a challenge requiring an effective intervention. While the first line has always been the use of intralesional triamcinolone, recently intralesional verapamil has also been known to reduce growth of keloids. Aim of the study was to evaluate the efficacy of both of these drug options. Literature searching was performed from three databases namely PubMed, Cochrane library and Science Direct. Findings were systematically narrowed down through inclusion and exclusion criteria into four relevant randomized controlled trials. Selected studies were critically appraised for its validity, importance, and applicability using tools from Oxford Center of Evidence-Based Medicine. Both intralesional triamcinolone and verapamil show their own benefit and risk. Triamcinolone is more effective in reducing keloid with faster improvement as seen in scar height reduction, vascularity, pigmentation and pliability. However, verapamil has fewer side effects which serve as a safer treatment option. More clinical trials in the future may be needed to obtain more conclusive result