Comparison of intralesional triamcinolone and intralesional verapamil in the treatment of keloids

Introduction: Keloid is an abnormal fibrous tissue outgrowth which extends beyond the borders of the wound. Intralesional triamcinolone acetonide is the most commonly used corticosteroid in the treatment of keloids. Intralesional Verapamil is an emerging treatment modality. Both of these drugs were compared to guide us towards better management of keloids by choosing the more appropriate treatment. Material and Methods: This was a randomized controlled single blind study conducted in the outpatient department of Dermatology unit II, Mayo Hospital Lahore, Pakistan. Eighty patients (40 in each group) were enrolled. Group A was given Intralesional Verapamil injection 1ml (2.5 mg) every month and group B was given Intralesional Triamcinolone acetonide (40mg) monthly. Patients were assessed at the beginning of the treatment and at the end of 3th injection. The clinical assessment of the scar was based on the Vancouver Scar Scale. Mean decrease in total score was calculated and patient’s keloid were photographed with a high quality digital camera, with consent. Results: Eighty patients, 42 (52.5%) male and 38 (47.5%) female were enrolled. The age of patients ranged from 12 to 40 with a mean age of 25.96 (±6.982) years. Most of the patients were between 21 to 30 years of age group. After the completion of study 58.28% reduction in the baseline score was seen in the triamcinolone group as compared to 36.75% in the verapamil group. Adverse drug reactions observed were pain in almost all patients, hypopigmentation in five patients and irregular menstrual cycles in two females with Triamcinolone. While only pain was observed with intralesional Verapamil. Conclusion: Intralesional verapamil can be used in the treatment of keloids but intralesional triamcinolone acetonide is better. Intralesional verapamil can give better results when used in combinatio