Evaluating the Therapeutic Success of Keloids Treated With Cryotherapy and Intralesional Corticosteroids Using Noninvasive Objective Measures

BACKGROUND Intralesional corticosteroid injections combined with cryotherapy are considered a first-line therapy for keloids. However, objective evaluation on its efficacy is widely missing. OBJECTIVE In this study, the authors evaluated the therapeutic benefits of cryotherapy directly followed by intralesional crystalline triamcinolone acetonide injections using ultrasound and a 3D topographic imaging device. MATERIALS AND METHODS Fifteen patients with keloids were treated with cryotherapy and intralesional injections of triamcinolone acetonide for a total of 4 times at intervals of 4 weeks. Objective assessment was performed at each visit. RESULTS After the last treatment, a significant average reduction of scar volume of 34.3% and an average decrease in scar height of 41.3% as determined by 3D imaging was observed compared with baseline. Ultrasound revealed an average reduction of scar height of 31.7% and an average decrease in tissue penetration depth of 37.8% when compared with baseline measurements. CONCLUSION Objective measurements of relevant keloid characteristics as height, volume, and penetration depth help in quantifying the therapeutic effect. The observed results confirm that intralesional injections of crystalline triamcinolone acetonide combined with cryotherapy represent a powerful approach to reduce scar height and volume significantly. Address correspondence and reprint requests to: Hannah Schwaiger, MD, Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337 Munich, Germany, or e-mail: hannah.schwaiger@web.de The authors have indicated no significant interest with commercial supporters. © 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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