Cocktail Treatment (Combination of 5-FU + TAC) in the Treament of Hypertophic Scars and Keloids
Notice bibliographique
Résumé
INTRODUCTION: Hypertrophic scars and keloids remain difficult problems, the treatment of which is both challenging and controversial1 Treatment modalities include established therapies like surgery, intralesional steroids, compression, silicon gel sheet; as well as more experimental therapies like interferon, intraleisonal bleomycin, intralesional 5-FU.2,3,4 The large number of treatment options reflects that there is no treatment, which is universally proven to be most effective. The present study has been done to compare the efficacy and safety of three drug regimens; intralesional triamcinolone acetonide (TAC) versus 5-Flurouracil (5-FU) versus combination of 5-FU + TAC in the treatment of keloids and hypertrophic scars. MATERIALS AND METHODS: A total of 32 patients (13 male and 19 female) were treated once weekly with intralesional treatment. Patients were divided into 3 groups: Group A received intralesional triamcinolone acetonide. Group B was treated with intralesional 5- Flurouracil. Group C patients were treated with the combination of 5-FU + TAC. Patients received 4 treatment sessions with an average injection volume of 0.2-0.4 mL / cm2. All patients had biopsy specimen taken before commencing treatment and after 4 sessions. The percentage of lesion volume reduction and symptoms of pain and pruritis were evaluated. Routine hematoxylin-eosin and immunohistochemical analysis detecting Ki-67 were performed. RESULTS: Patients who received the combination of 5-FU + TAC (group C) had a 79.33 % change in volume of scar compared to 39.74 % in the group of patients receiving steroid (TAC) monotherapy (group A), which was statistically significant (p=0.001). Vancouver Scar Score (VSS), Visual Analog Scale (pain), VAS (pruritis) showed an improved response in patients receiving the combination treatment as compared to monotherapy. Differences in complication rates were significantly better in combination group as compared to monotherapy group. Histopathologic and immunohistochemical evaluation were consistent with the clinical observations. Ki-67 proliferative index, was significantly reduced after treatment with 5-FU (p value 0.001), and combined 5-FU + TAC (p value 0.003). CONCLUSION: Our study found that the cocktail treatment (combination of 5-FU + TAC) was more effective and better tolerated than 5-FU or TAC monotherapy, in the treatment of hypertrophic scars and keloids. Thus, cocktail treatment (combination of 5-FU + TAC) should be placed ahead of triamcinolone acetonide (TAC) in the treatment of hypertrophic scars and keloids.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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