Original Article
Safety of combination of pulsed dye laser followed by intralesional triamcinolone acetonide and intralesional triamcinolone acetonide alone in the treatment of keloid – a study on 50 case
Author Details
1. Department of Dermatology, Jaber Al-Ahmed Armed Forces Hospital, Kuwait.
2. Junior Consultant, Department of Dermatology, Dhaka Medical College Hospital.
Abstract Background: Keloids are benign fibroproliferative lesions that extend beyond the original wound margins, often causing cosmetic disfigurement, discomfort, and psychosocial distress. Their high recurrence rates and resistance to conventional therapy make management challenging. Although various modalities such as surgery, corticosteroid injections, cryotherapy, radiotherapy, and laser treatments are available, no single method has shown consistent long-term superiority. Objective: To evaluate the safety and any associated side effects or complications of pulsed dye laser (PDL) followed by intralesional triamcinolone acetonide versus triamcinolone alone in keloid management. Methods: This randomized comparative study enrolled 50 patients with clinically diagnosed keloids at the Department of Dermatology & Venereology, Combined Military Hospital, Dhaka. Patients were allocated into two groups (n = 25 each). Group A received PDL immediately followed by intralesional triamcinolone acetonide (40 mg/mL), while Group B received triamcinolone alone. Injections were delivered intradermally using a 30-gauge needle and 1 mL insulin syringe under aseptic conditions, with dosing adjusted according to clinical response. Outcomes were assessed at baseline and at 4, 8, and 12 weeks, focusing on safety, adverse effects, and clinical improvement. Results: Both groups tolerated treatment well, with no serious adverse events. Combination therapy produced greater improvement than steroid alone, with earlier lesion softening and better overall response. The enhanced efficacy was atiributed to PDL-induced edema, which may increase steroid penetration. Conclusion: Both methods were found to be individually safe. However, the combination of PDL and intralesional triamcinolone acetonide offers a safer approach that produces better clinical outcomes and quicker lesion softening compared to steroid injection alone, without added safety concerns. Keyword: Keloid, pulsed dye laser, intralesional triamcinolone acetonide. |
Keywords: Keloid, Pulsed Dye Laser, Intralesional Triamcinolone Acetonide