P60 Intralesional steroids vs. liquid nitrogen cryotherapy vs. 595 nm pulsed dye laser in the management of chest keloids: a comparative study
Bibliographic record
Abstract
Abstract Chest keloids often result in cosmetic disfigurement, contractures, pruritus and pain. Inflammatory truncal acne often triggers chest keloid. Management is often challenging as they are relatively resistant to treatment and recurrence rates are high. The objective of the study was to compare the clinical efficacy and safety of intralesional triamcinolone acetonide (40 mg mL−1) vs. liquid nitrogen cryotherapy vs. 595 nm pulsed dye laser in the management of chest keloids. We conducted a comparative prospective study in a total of 42 patients with chest keloids from July 2021 to July 2022. These patients were randomly divided into three treatment groups via the envelope method. The Vancouver Scar Scale (VSS) was used to assess the clinical efficacy of the treatment modality. Patients were scored at the initiation of therapy and every 4 weeks until 16 weeks. Seven patients were lost to follow-up (response rate 83%). Treatment arms consisted of intralesional triamcinolone acetonide (n = 10), liquid nitrogen cryotherapy (n = 11) and pulsed dye laser (n = 14). There was a near-equal sex distribution of chest keloids (male-to-female ratio 1.21 : 1), with 15 patients (35.7%) having additional keloids in other body parts. The mean (SD) age of patients with chest keloids was 27.2 (13.6) years with a common incidence in those aged 20–30 years. Comparison of mean VSS as baseline and at 16 weeks revealed a statistically significant decrease in the score in all three treatment arms (P < 0.05). Comparison between the three different treatment arms revealed pulsed dye laser to be the most effective modality in decreasing VSS at the 16-week follow-up (Anova followed by post hoc analysis with Tukey’s test). With regard to the adverse clinical event profile, acneiform eruptions were reported following steroid injections, blistering and depigmentation were reported following liquid nitrogen cryotherapy, and blistering was reported following pulsed dye laser therapy. Thus, the pulsed dye laser (595 nm) appears to be a safe and efficacious treatment modality in the management of chest keloids.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".