Letter to the Editor: Unlocking Better Keloid Treatment: Corticosteroid, 5‐Fluorouracil, and Hyaluronidase vs. Corticosteroid Alone—A Randomized Comparative Study
Notice bibliographique
Résumé
I read the article titled “Unlocking Better Keloid Treatment: Corticosteroid, 5-Fluorouracil, and Hyaluronidase versus Corticosteroid Alone—A Randomized Comparative Study” by Ehsani et al. with great interest. The study by Ehsani et al. introduces an innovative approach for treating keloid scars through a triple-drug intralesional injection combining triamcinolone acetonide, 5-fluorouracil (5-FU), and hyaluronidase [1]. Their findings highlight superior outcomes in lesion height reduction, pliability, and Modified Vancouver Scar Scale (MVSS) scores compared to corticosteroid monotherapy. The biological rationale for adding hyaluronidase due to its potential to mitigate fibroblast proliferation and enhance drug spread adds depth to the study's clinical relevance. However, the inability to isolate hyaluronidase's independent effect due to the absence of a steroid + 5-FU comparison group needs further discussion. Methodologically, the trial presents several considerations, primarily due to its small sample size of sixteen participants (n = 16), which affects statistical power and generalizability. Although nonparametric tests were appropriately applied, the lack of reported effect sizes weakens the interpretability of the results [2]. Furthermore, the single-blinded design, with patients aware of their treatment group, introduces performance bias that may affect subjective measures such as pain and pruritus [3]. While there were positive trends in these outcomes, they did not reach statistical significance, likely due to both small sample size and potential placebo effects. Biological confounders also emerge in this trial. Including hyaluronidase seems logical due to its role in modulating interleukin-1 and remodeling tissue; however, its effect is hard to separate from the well-established effects of 5-FU and triamcinolone [4]. Furthermore, the authors detected better outcomes in color change, but differences in initial scar pigmentation between groups undermine this finding. Moreover, the short follow-up duration of 2 months is insufficient to assess the risk of keloid recurrence, which is a key consideration in evaluating any scar therapy [5]. To strengthen future research, larger multicenter trials with extended follow-up are needed. A multi-arm design isolating the effects of individual agents would provide greater clarity, while a double-blinded methodology could minimize bias and improve validity. Stratification by lesion site and prior treatment history may also yield more refined insights. Despite its limitations, this study offers an encouraging step toward reducing the burden of keloids and underscores the promise of hyaluronidase as a potentially transformative therapeutic agent. Asifa Zardari: writing – original draft, conceptualization, investigation, visualization, writing – review and editing. I would like to sincerely acknowledge Dr. Muhammad Umar from Khairpur Medical College, Khairpur Mirs, Pakistan Email: [email protected] for his continued support and mentorship throughout the preparation and publication of this article. Permission to include his name has been obtained. The author declares no conflicts of interest. The author has nothing to report.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
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 | 0,003 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| 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.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».