A comparative study of the effectiveness and safety of injectable combination therapy of keloid and hypertrophic scars with 5-fluorouracil and betamethasone

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Abstract

therapy for their reliable removal. Standard methods of treatment often give unpredictable results, are accompanied by various complications, and require the use of expensive equipment.

AIM: To investigate the efficacy and safety of intralesional injection of a combination of 5-fluorouracil (5-FU) and betamethasone for the treatment of keloids and hypertrophic scars.

MATERIALS AND METHODS: The study involved 26 patients who were divided into two equal groups. Patients in group A received intralesional injections of betamethasone, and those in group B received 5-FU and betamethasone. Three injections were performed with an interval of 3 weeks. The scars were assessed at the beginning of the treatment, on the 3rd and 6th week during the treatment, and 4 and 16 weeks after the end of the treatment. The dynamics of scar condition was evaluated by the average decrease in the scar height and density, changes in subjective sensations, and the presence or absence of complications.

RESULTS: At 4 weeks after the end of the therapy, the total effectiveness of reducing the initial scar height was significantly higher in group B (10 patients; 76.9%) than in group A (6; 46.1%). In the comparison of long-term results at 16 weeks after treatment, 92.3% of the patients from group B and 53.8% of the patients from group A showed cessation of scar growth, flattening and softening, diminished itching and pain, smoothing of the scar contour, and a decrease in the color of the border between the scar and surrounding tissues.

CONCLUSIONS: The combination of betamethasone with 5-FU is safer and more effective than monotherapy with betamethasone or 5-FU in the treatment of keloid and hypertrophic scars, with a faster and more pronounced decrease in the height and density of the scar, erythema, and subjective sensations. This mode of therapy is characterized by a low relapse rate with prolonged follow-up. The article is of interest to practicing cosmetologists, dermatologists, and plastic surgeons.

About the authors

Evgeniya V. Ikonnikova

Central State Medical Academy General Management Department of the President of the Russian Federation; Institute of Plastic Surgery and Cosmetology

Author for correspondence.
Email: evikonnikova@bk.ru
ORCID iD: 0000-0002-8813-9132

Associate Professor of the Department of Dermatovenereology and Cosmetology

Russian Federation, Moscow; Moscow

Larisa S. Kruglova

Central State Medical Academy General Management Department of the President of the Russian Federation; Institute of Plastic Surgery and Cosmetology

Email: kruglovals@mail.ru
ORCID iD: 0000-0002-5044-5265

MD, PhD, professor, Central State Medical Academy Management of Affairs of the President Russian Federation, Moscow

Russian Federation, Moscow; Moscow

Nataliya E. Manturova

Institute of Plastic Surgery and Cosmetology; Pirogov Russian National Research Medical University

Email: manturovane@mail.ru
ORCID iD: 0000-0003-4281-1947

Head of the Department of Plastic and Reconstructive Surgery, Cosmetology and Cell Technologies, N.I. Pirogova, Doctor of Medical Science

Russian Federation, Moscow; Moscow

Marina A. Petrii

Central State Medical Academy General Management Department of the President of the Russian Federation

Email: marina0301nikolaeva@gmail.com
ORCID iD: 0000-0003-2559-1719
Russian Federation, Moscow

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