Assessment of Treatment Modalities in Patients With Keloids: A Vancouver Scale Comparison

Ann Dermatol. 2024 Dec;36(6):348-354. doi: 10.5021/ad.23.160.

Abstract

Background: Various treatment modalities are used to treat keloids. However, a comprehensive assessment comparing the effectiveness of these modalities in terms of patient-reported outcomes is warranted.

Objective: To assess and compare the effectiveness of various treatment modalities for keloids.

Methods: We assessed treatment outcomes in a cohort of 250 patients diagnosed with keloids. The patients were categorized into four treatment groups: triamcinolone acetonide (TA), TA + cryotherapy, TA + pulsed dye laser (PDL), and TA + cryotherapy + PDL. The Vancouver Scar Scale was used to evaluate the keloid severity before and after treatment.

Results: Significant differences were noted in the Vancouver Scale scores among the treatment groups (p=0.023). Notably, the TA + cryotherapy + PDL group exhibited the most substantial improvement in the Vancouver Scale scores, whereas the TA + PDL group showed the least difference. Pliability was the most significantly improved in the TA + cryotherapy + PDL group (p=0.039). Male patients experienced a greater reduction in pigmentation scores than female patients (p=0.037).

Conclusion: Our findings highlight the effectiveness of combined therapies, particularly TA + cryotherapy + PDL, in improving keloid-related parameters. These results offer valuable insights for clinicians in tailoring keloid treatment strategies and support the implementation of combination therapies for enhanced outcomes. This study underscores the importance of comprehensively assessing treatment modalities for keloid management. Combination therapies such as TA + cryotherapy + PDL irradiation have demonstrated significant promise in improving keloid characteristics.

Keywords: Cryotherapy; Hypertrophic scar; Keloid; Pulsed dye laser; Triamcinolone acetonide.